Okayama University Medical School

The idiopathic thrombocytopenic purpura was described by Werlhof as an independent disease first in 1738. Kaznelson reported the excellent effect of splenectomy for its chronic type in 1915. For the genesis of its thrombocytopenia, there have been many theories to be concluded into the followings, 1) the development of an auto-immune mechanism resulting in platelet destruction, 2) increased platelet destruction in the spleen, 3) the inhibition of platelet production from the marrow megakaryocytes by a humoral factor produced in the spleen, 4) both increased destruction and decreased production of the platelet. Among the above four theories, the third one is the most popular in the chronic type.

In decerebrated cats the impulse discharges were detected by means of an unipolar microelectrode from a single inspiratory neuron in the respiratory centers, and the change in discharge produced by administration of stimulating, as well as depressant agents, was studied. The results were summarized as follows. 1) Inhalation of the air containing all. excess of carbon dioxide, as well as the air deficient of oxygen and the intravenous administration of a small dose of caffeine, aminocordine and lobeline produced a) a remarkable increase of frequency of impulses in the stage of constant frequency of the volley, b) a rapid increase of frequency of impulses in the stage of crescent frequency of the volley and c) a shortening of the duration of the volleys, as well as of silent periods. 2) In narcosis by a moderate dose of morphine, as well as in the recovery stage from apnea produced by over-ventilation, there were observed the phenomena which were exactly opposite to those described in 1). 3) It was concluded that a most essential sign by which one can discern whether the activity of the respiratory Genters is raised or depressed, is the changes of the frequency of impulses produced from an inspiratory neuron. The expense of this research was defrayed from the grant in aid of the Ministry of Education.

Our methods of tissue culture of the bone marrow, lymphnodes, and peripheral blood were described. Furthermore, for the purpose of promoting wide clinical application of bone marrow tissue culture, our simple vital inspection method was also stated.

1. Sinomenine and Irgapyrin, the two antirheumatics known to be capable of releasing histamine, caused a marked gastric secretion in the unanesthetized dog. 2. The facial edema and itching associated with histamine release by sinomenine was almost completely eliminated by NeoAntergan, but the gastric secretion was not suppressed, or rather increased - an observation also reported by Paton and Schachter with Compound 48/80. This indicates that the histamine release cannot be markedly prevented by antihistamine agents in this animal. 3. The gastric secretion induced by Irgapyrin was not suppressed by Neo-Antergan but Irgapyrin originally never caused other symptoms associated with histamine release. This is probably due to the antihistamine action inherent in this compound itself. 4. No such histamine-releasing activity, as determined by gastric secretion, could be observed in aminopyrine or butazolidine sodium, the components of Irgapyrin. 5. Sinomenine, differing from Irgapyrin and Compound 48/80, was ineffective by intramuscular injection.

(1) The movement of the blood cells in the bone marrow was classified into 9 types. (2) The characteristics of moving types are so distinct according to the kinds of blood cells, that the differential diagnosis of the cells by moving types is easily and certainly made. In this way, (by the kind of blood cells), we have classified leukemia, as is described in our other articles. (3) The phagocytosis and vital staining of the blood cells in the bone marrow is different in degree and mode, according to the kind of blood cells, and thus becomes valuable ground for the differential diagnosis of the cells.

1) As the boundary of the outgrowth zone of the bone marrow culture is sharply defined from the surrounding area and the cellular density becomes very high in leukemia, diagnosis can be made with ease and certainty. 2) The differential diagnosis between aleukemic leukemia and aplastic anemia becomes easy by application of the tissue cuIture method. 3) The vital observation of blood cells were used in classification of leukemia by cellular systems, and it was discovered that there were a lot of patients with monocytic leukemia and relatively many with acute lymphatic leukemia. 4) Because the cellular growth in the bone marrow culture of aplastic anemia declines extremely and abundant fat cells are observed, the diagnosis of this disease is easily made by employment of this method.

Blood cells of schizophrenics differ in many points from those of normal subjects. First of all the shape of them is flat and thin. This tendency is more marked in old group than in new group; the volume is small; flat corpuscles are more numerous in them in the normal; and the blood resistance against diluted saline solution is stronger than that of the normal. It has long since been known that the rate of corpuscle sedimentation is being accelerated in schizophrenics. A simple physical cause that blood corpuscles are flat and numerous can explain this phenomenon. It is said that there is an antisphering substance among the factors controlling the thickness and roundness of blood corpuscles. Yet it has not been determined whether this substance on the surface of the blood of schizophrenics is large or small. Blood corpuscles are said to lose their peculiar disc-shape and to be completely destroyed at the pH of 9.2 when the antisphering substance is removed from the surface of blood corpuscles. The lower the pH is the better is the absorption of this substance on the surface of blood corpuscles; and it seems that the more this substance attaches itself to blood corpuscles the greater is the degree of flatness and in this connection it is interesting to note that the pH of schizophrenic blood is low in low in general. On the other hand, however, sphericity is increased at the time when the acidity of blood is increased due to a sudden movement of acidic substances immediately after ECT. Again in the case of coma of insulin treatment, blood tends to be alkaline and even then an increase in the sphericity of corpuscles is indicated. Consequently it seems tnat the roundness of blood corpuscles is not solely dependent upon antisphering substance and pH.

Two forms of the direct bilirubin separated from the dried canine cholecystic bile were subjected to paper chromatography and emission or infra-red spectroscopy, and the following results were obtained: 1. The two forms of the direct bilirubin contain plenty of bile acid or its salt, and benzidine- and ninhydrine-positive substances together with various inorganic elements were also detected. 2. The ester-form bilirubin had carboxyl radical by infrared spectroscopy. But it will not be easily concluded that an existence of carboxyl radical will owe to free carboxyl radical of the dibasic acid bilirubin by the reason why an existence of plenty of bile acid in the sample may inhibit the characteristic absorption of ester. 3. It may be suggested that the two forms of the direct bilirubin combine with bile acid or its salt, and that the affinity between them is stronger in the salt-form bilirubin. 4. It seems probable that properties of the salt-form and ester-form bilirubins are not influenced by an existence of bile acid or its salt, and further by acornbination with it.

Histopathological investigations were carried out on five fatal cases of a type of polyneuritis of unknown etiology diagnosed as Landry-Guillain-Barre syndrome, which endemically occurred in children in the regions surrounding the Inland Sea of Japan. The most characteristic pathologic feature in the nervous system was pronounced patchy degenerative changes with slight or moderate degree of inflammatory cell response of focal type in the peripheral and cranial nerves, predominantly in the nerve fibers of the spinal and cranial roots. In the spinal cord, medulla, pons, and in some portions of the cerebrum and cerebellum, engorgement of the small blood vessels as well as edema and the less predominant scattered degenerative changes of ganglioncells and nerve fibers with extremely slight degree of glial response and sparse perivascular cell collections were encountered. The cerebrospinal meninges displayed edema and congestion of the pial blood vessels with focal collections of a small number of lymphocytes and/or monocytes. No advanced involvement of the anterior horn of the spinal cord in a strict sense of anterior poliomyelitis was, however, recognized. These changes may lead the histopathologic diagnosis of the present disease to infectious encephalomyelo-polyradiculoneuritis or a type of infectious polyneuritis. The main histopathologic changes in the visceral organs were a moderate degree of engorgement of the small blood vessels, degeneration of parencymatous organs such as the liver and kidney, hyperplasia or follicular atrophy of the lymphatic tissues, interalveolar pneumonia, focal myositis, and slight degree of round cell infiltrations in the interstitial tissues of the other viscera, such as the liver, heart, and gastrointestinal canal. Based upon the observations on the histopathological changes as well as clinical manifestations, discussions were made on the pathogenesis and etiologic factor of the present endemic disease with critique on the literatures.

For the purpose of obtaining the dibasic acid indirect bilirubin in a pure state from the dried canine cholecystic bile, an optimal developing solvent was selected by paper partition chromatography as a preliminary experiment, and it was isolated on cellulose column as an applied experiment. 1. The dibasic acid indirect bilirubin was separable at the starting point in a pure state by paper chromatography under development with the top layer of a n-butanol, acetic acid, water mixture (4:1:5). 2. The dibasic acid indirect bilirubin formed a fixed band at the upper starting place on cellulose column under development with the top layer of a n-butanol, acetic acid, water mixture (4:1:5), and no other substance could be detected there. 3. The dibasic acid indirect bilirubin existing in the fixed band could be eluted out into chloroform with a 1% acetic acid solution. An orange yellow powder was obtained from the eluate by evaporating the solvent in vacuo. 4. Thus separated orange yellow powder agreed well with the crystalline bilirubin in the solubility into organic or inorganic solvents and in the spectrochemical characteristics as well as in the chemical properties.

The existence of autonomic adjustment functions of eye pressure was demonstrated in various ways, both clinically and experimentally. It is possible to consider that in normal condition, I.O.P. is controlled autonomically like cardiac or respiratory rate irrespective of the internal or external influences of the body. The auther calls such a phenomenon "autonomic eye pressure adjustment function". The mechanism of this physiological function will be reported on in articles to follow.

To reveal the relationship between the morphologic structure and the functioning of cells it is of great importance to know the molecular arrangement in cytoplasm. For this purpose the observation by polarization microscope is one of the most exellent methods. There are several excellent works on nerve fibre done using polarized lightl,2,3,4 but there is no report concerning the nerve cell itself. It is the purpose of this paper to show our data obtained on ganglion cells and nerve fibres with the deduced speculation on the structural arrangement of lipoprotein in the protoplasm of nerve cells and fibres.

In 1955 SANO found mitochondria by the supravital stain with Janus green B in the basophilic stippled cells from the circulating blood of the lead intoxicated rabbitsl , and in 1956 by means of electronmicroscope VALLEJO-FREIRE, BRUNNER et al. found mitochondria in the reticulocytes2,3, and later at the end of 1956 BRAUNSTEINER et al. also succeeded in revealing mitochondria and the vesicular structure by electron microscope in the ultra thin section of young red cells4. We also have found the mitochondria and the endoplasmic reticulum in young red cells. It has been discussed long whether the reticulum of reticulocytes is a preexistent structure or an artifact. The fact that the mitochondria exist in the reticulocyte seems to support strongly the preexistence theory of the reticulum, substantia reticulo filamentosa. However, the fact that the reticulum has several characteristics different from the general mitochondria5,6 can not be ignored. In this paper we should like to demonstrate the photos of mitochondria and the endoplasmic reticulum in the denucleated red cells revealed by electron microscope comparing to the picture of reticuluocyte appeared by supravital stain.

We have designed to apply 2-pyridine aldoxime methiodide(PAM), considered to be a cholinesterase reactivator in vitro, both to the laboratory rabbits poisoned by parathion and to the patients of parathion poisoning, and obtained the following results: 1. With administration of PAM, a prompt and complete dispersion of symptoms of the poisoning can be realized. 2. Cholinesterase activity of red blood cell has instantly and completely recovered, and that of serum transiently. 3. The amount of serum mucoprotein and the activity of active protein-SH-radical of serum varied in direct proportion to the activity of serum cholinesterase. 4. Generally, an intravenous injection of 1g. PAM is sufficient even in the severe case and it may be increased when necessary. 5. The ill effect has not been encountered in the PAM administration. 6. PAM exerts no influence on the cholinesterase activity of normal blood. 7. PAM is expected to play an important role as a prophylactic agent of alkylphosphate poisoning. From these results it seems clear that PAM is a specific and effective antidote against alkylphosphate intoxication.

1. The shell of the ova of Enterobius vermicularis is composed of two chitinous layers, a compact outer layer and a looser inner layer. Both surfaces of the two layers have a dense border. 2. The outer layer has innumerable tubules about 0.2 micron in diameter, and only those tubules found in the thinner part of the layer open to the outside and inside. 3. The outer layer of mature eggs is about 0.45 micron and the inner layer about 2 to 6 microns, in thickness. 4. The chitinous microfibrils in both layers form a rcticular structure which contains very fine granules in the mesh.

In order to produce vomiting in the dogs decerebrated and unanesthetized, apomorphine or copper sulfate was administered. The behaviors of both the inspiratory and the expiratory muscles were studied through the course of the act of vomiting by the electromyographic technique. The results are summarized as follows: (1) The most significant signs of vomiting seems to be the recurrent vomiting volleys from the vomiting center each of which is produced abruptly and transiently. (2) The peculiarities of the vomitng volley consist in the simultaneous discharges of both the inspiratory and the expiratory muscles, resulting in the so-called retching movement. (3) The vomiting volleys, in their rhythm, seem to arise independent of the respiratory center, but the former are capable of affecting the respiratory centers at any respiratory phase. (4) The acceleration of the breathings observed prior to the retching seems to be due to the invigorated activity of the respiratory centers affected directly by the administration of the vomiting agents without an intermediate step by the vomiting centers. (5) The simultaneous contraction of the diaphragm and the abdominal muscles are merely a component of a peculiar type of the respiratory movements, namely, that of the retching. (6) The glottis muscles are, however, ruled out from the principle described in (2): the closer of the glottis muscles contracts during the retching, while the opener is completely inhibited.

Recording the motility of the stomach as well as the small intestine by the balloon method in the dogs decerebrated and unanesthetized, we found a factor conditioning the inhibitory effect of the intestinal motility to the stimulation of the perpheral cut-end of cervical vagus nerves. The results may be summarized as follows: (1) The stimulation of the peripheral cut-end of the cervical vagus nerve frequently produces the yarious patterns and degrees of inhibition of the intestinal motility of the stomach as well as of the small intestine. (2) The inhibitory effect still appears after the severing of the vagus nerves at the caudal end of the esophagus, but is obliterated and reversed to the augmentory when the splanchnic nerves are bilaterally severed. (3) The cause of the inhibition is attributable to the strong excitation of the intestinal inhibitory centers brought about by the central stimulating action of the anoxemia resulting from the stimulation of the cervical vagus nerves, and the reversal of the response is due to the peripheral stimulating action of the anoxemia upon the intestinal muscles, its central action being excluded from the action on the intestine by the severing of the splanchnic nerves.

From the results of various experiments in an attempt to investigate the relationship between the intraocular pressure and the ophthalmic nerve, the author has come to the conclusion that the ophathalmic nerve is one of the afferent pathways transmitting the various impulses caused by the changes in the intraocular pressure to the autonomic eye pressure center, and the impulses created by these stimuli in the eye pressure center are in turn transmitted to the eyeball by way of the autonomic nerves and thus the eye pressure is autonomically regulated by these reflexes.

A sanitary mass-disposal of nightsoil constitutes one of the major public health problems in the majority of Japanese cities and towns. Under the present economic situations in Japan, however, a low construction and operation cost and a simple disposal plant easy to operate are most essential to meet the prevailing needs, not to speak of complete destruction of pathogenic bacterial and parasitic organisms contained in the excreta to be disposed of.

From these experimental results, the author has reached the following conclusion: The choroid possesses abundant blood vessels, and inasmuch as they carry a large amount of blood on account of their large tubular space, they also have such structural formation as to enable their distension or contraction greatly to influence the volume of intraocular contents. Moreover, as the autonomic nerves distributed in the eye are connected with the wall of vessels in a compact network of nerve fibers, the width of the choroidal vessel can be regulated by the autonomic center ; and thus the intraocular pressure seems to be regulated by an increase or a decrease in the amount of intraocular circulating blood. On the other hand, the ciliary body likewise seems to take a part in the adjustment of the eyepressure as the width of vessels, the permeability of blood vessel walls, and the aqueous production are all controlled by the autonomic nerve, and because the contraction of ciliary muscles, as already mentioned, also exerts a great influence on the intraocular pressure. Therefore, the author believes that a regional adjustment of eye pressure is being performed by these mechanisms, working as they are in conjunction with each other, and maintaining a harmonious relation among themselves under the control of the autonomic center.