Okayama University Medical School

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.

The author has carried out the investigations from various angles on the relationship between the function of diencephalon and the eye pressure, and has found that all the evidences in the investigations point to a quite important role being played by the diencephalon in regulation of the eye pressure. Today it is a common physio-anatomical knowledge that the functions such as respiration, pulsation, blood pressure, and digestive actions which are essential for the maintenance of life, all possessing autonomy, are performed and regulated by the centers existing in the diencephalon. Now, the eye pressure, having such an important relationship to the visual functions, can not possibly be a lone exception. From these, therefore, it may be concluded that at least an autonomic center of the eye pressure exists in the diencephalon.

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.

1. Adversive movements were induced by electrical stimulation and metrazol injection on area 4c of the cerebral cortex. 2. The adversive movement from area 4c does not pass through the thalamus, nucleus caudatus, nucleus lenticularis or superior collicuIus, but through direct efferent pathways in the internal capsule. 3. The adversive movement from area 4c passes through the pyramidal tract.

1. The rates of histamine release from the liver, skin and muscle by four kinds of histamine-releasing substances, sinomenine, compound 48/80, tween 20 and polyvinylpyrrolidone (PVP), were compared by intravenous injection in dogs, each in a dosage to cause a fall of approximately 80 per cent in the arterial blood pressure. 2. By compound 48/80, the rates were especially marked from the liver and muscle and only slight from the skin, while those by sinomenine, tween 20 and PVP were largest from the skin, followed by those from the liver and muscle, in that order. The rate of histamine release from the skin by PVP was characteristic in that it was far larger than that by other releasers. 3. On direct application of the drug solutions to the excised tissues of the liver and skin the rates of release of histamine differed only slightly by the tissue in any of these releasers 4. Some considerations were given on the reason for the different ratios by the organ of in vivo histamine release though as yet no definite conclusion could be drawn.

The evaluations of the basal metabolism before the operation, at the completion, and at the follow-up examinations, have been conducted on the patients with cervical carcinoma, all under the age of 50 years, and operated on in the Clinics of Obstetrics and Gynecology, Okayama University Medical School and the following results are obtained: 1. The basal metabolism of the patients with cervical carcinoma of either stage I or stage II as compared with that of the normal women is more accelerated; while the basal metabolism of the cervical carcinoma of stage II. is more augmented than that of the cervical carcinoma stage I. 2. The basal metabolism at the completion of operation is markedly lower than that before the operation. 3. In those who received the autotransplantation of the ovary concomitantly with operation, the basal metabolism once increases at the 4th month after the operation and after that it maintains a low stable state. 4. The basal metabolism of those who received the operative castration continues increasing up to the 8th month after the operation and thereafter it returns to a rather balanced state. 5. From the aspects of the fluctuations of the basal metabolism, it has been recognized that the autotransplantation as compared with the castration exerts less influences on the somatic system and for a shorter period of time, and also the endocrine system of the former returns to the balanced condition earlier.

The analgesic effects of morphine and some related compounds, such as meperidine, observed by the conventional method, are supplemented by the release of epinephrine from the adrenal medulla. It is assumed that this action of epinephrine is not due to an additive synergy in the analgesic effect but to the face that the action of epinephrine on a definite higher center or centers effects synergistically in the reflex depressant action of these analgesic agants. This assumption is based on the following evidences. Prolongation of reaction time in mice by morphine and meperidine (but not by ohton), determined by the hot-plate method, was significantly reduced by adrenalectomy and this reduction was normalized by the concurrent use of epinephrine, in a small dose which in itself cannot prolong the reaction time. No such action was found in cortisone and DOCA. The effects of morphine and meperidine in prolonging the reaction time were reduced by priscol and dibenamine, as well as by tetraethylammonium salt. A large dose of pyrazolone derivatives causes, not the prolongation of reaction time but a jumping reflex response in the early stages, indicating central excitation, in part of the mice. The ratio of mice exhibiting such an early reflex increases with adrenalectomy or the administration of dibenamine, and is markedly decreased by epinephrine, insufficient to show any analgesic response by itself, and by cortisone. This action of cortisone indicates some difference in the natures of central excitation by pyrazolones and by morphine. Judging from the work of SCHAYER18, the distribution in the brain of epinephrine injected in the dose to normalize the reduced effect of morphine in the adrenalectomized mice, may also be anticipated by the epinephrine which might be released from the adrenal medulla by morphine in an amount much smaller than the "near·lethal doses9 ".

1) Cerebellar convulsion was identical with the cerebral cortical epileptic convulsion and the number of cases in which the march of spasm was observed were quite the same as that of cases in which convulsion occurred at the same time on the whole body. 2) No convulsion occurred by stimulation of the vermis cerebellaris and also convulsions occurred very rarely by that of the cerebellar nuclei. 3) In cases having the march of spasm caused by stimulation of the lobus lunatus anterior, spasm began in the fore limb, while by stimulation of the lobus lunatus inferior and lobus semilunaris spasm started mainly in the hind limb on the side of stimulation. 4) In the case of stimulation of cerebellum, the pathway of the impulse to the opposite side was considered to be the communication between both cerebellar hemispheres and both thalami and thus the march of spasm spread from one side of the body to the other side. 5) No march of cerebellar epileptic convulsion occurred without the cerebral motor cortex. 6) After the removal of both sides of the cerebral motor cortex no march occurred, but the general convulsion occurred. 7) No convulsion occurred by stimulation of the cerebellar hemisphere after the removal of both thalami or both nuclei lenticulares. 8) The march of convulsion occurs by close cooperation of the pyramidal and extrapyramidal tracts. It seems that for the impulse of the convulsion the extrapyramidal tract plays an important role, while for the start of the convulsion, that is, march of spasm pyramidal tract plays the main role.

1) The contents of sialic acid in patients of various diseases sera were determined and increases of it were noticed in several diseases. 2) Sialic acid contents ranged between 50 and 100 mg./dl. in the normal serum. 3) But in the pathological serum, it ranged between 90 and 170 mg./dl. in cancer patients, between 80 and 110 mg./dl. in peptic ulcer, between 75 and 135 mg./dl. in arachnoiditis, and between 90 and 120 mg./dl. in epilepsy. 4) In other several diseases, sialic acid contents were determined.

The purpose of the present study is to reveal the precise mechanism of nervous and humoral regulations of lipid and carbohydrate metabolisms in the adipose tissues. Histochemical and biochemical observations were made on the innervated and denervated interscapular brown adipose tissues and partly on the liver and adrenal cortex of male mice during starvation with or without carbohydrate introduction with special consideration to the changes of the lipid and glycogen contents and to the activities of several important enzymes as well as to pH values in the tissues. In a state of absolute starvation, the animals died in a few days showing a gradual discharge of stored lipids from the innervated brown adipose tissues, while in the denervated tissues the stored lipids increased gradually even in a state of slight or moderate starvation as well as in the cases of normally fed animals. The increase of lipids continued before the stage of severe starvation and the stored lipids being rapidly discharged became nil at the terminal stage of life. Introduction of glucose into starved animals caused also a more marked deposition of glycogen in the denervated than in the innervated tissues in proportion to the degree of starvation, although it did not cause the deposition in both tissues at the terminal stage of life. These facts represent that the nervous regulation is essential for the mobilization of lipids and carbohydrates from this tissue. Adrenalectomy also caused the death of animals within a few days with a gradual decrease of depot lipids. In this case denervation likewise caused a marked depositon of lipids in the brown adipose tissues, showing a sudden escape of lipids at the end of life. Experiments on transplanted adipose tissues taken from the animals at the terminal stage of starvation, proved that the tissue cells retain the ability to deposit lipids until the end of life. Chemical estimation elucidated that the serum glucose and lipids fall markedly at the terminal stage of life. The innervated tissues showed increased activities of succinic dehydrogenase, alkaline phosphatase, ATPase and lipase during starvation with a gradual discharge of lipids. Glucose injection increased the degree of the activities of all these enzymes, though in the terminal stage of starvation the ATPase activity declined again. The activity of total cholinesterase declined slightly in severe starvation. The pH value fell gradually with the progress of starvation. On the other hand, in the denervated tissues the activity of succinic dehydrogenase fell with an increased deposition of lipids, though in the final stage of starvation the activity rose with the discharge of lipids; while the activities of phosphatase, ATPase and lipase rose during starvation and total, unspecific and specific cholinesterase activities declined slightly. The pH value in the denervated tissues rose slightly during mild starvation and fell markedly in severe starvation. Observations proved that the activities Df these enzymes and pH, which are under the control of the autonomic nervous system, have close relationships to the deposition and the discharge of lipids and glycogen from the adipose tissues, and that the rapid discharge of lipids from the denervated tissue at the terminal stage of life is an expression of the onesided progress of oxidative process which may mean a complete loss of regulation of metabolism.

From the results of the various tests thus far mentioned, it may be said that of the patients with primary glaucoma, be it. inflammatory or simple, the majority point to the functional disturbances and unbalanced conditions of the diencephalo-hypophyseal system as well as of the autonomic system, and that their autonomic adjustment functions of the eye pressure as compared with those of the normal are considerably disturbed and are in unbalanced state.

For the periods ranging from the fifth gravid month to the sixth post partum week continuous examinations were conducted on the blood picture of 10 multiparas and 18 primipars who came to the Second Maternity Hospita, Okayama University Medical School, from December 1955 to December 1956, and all those who had no complications throughout pregnancy, delivery and puerperium. In addition observations were carried on the 245 subjects who had no complibation throught pregnancy, delivery and puerperium to see what influences the blood loss during delivery might exert on blood picture during puerperium, particularly the changes of hemoglobin concentration (Hb), and the author arrived at the following conclusions: 1) By the continuous examinations of pregnat women the existence has been recognized of physiological anemia which recovers close to the level of healthy non-pregnant women within one month after delivery. Namely, it has been found that already by the fifth month of pregnancy a considerable decrease both in erythrocyte counts and Hb values is recognized as compared with those of healthy non-pregnant women (the control), but starting around the eighth month the values of both keep on increasing month after month until reaching their maximum at delivery yet still a little below those of the control, and particularly Hb values as compared with those of the control show a significant fall. During puerperium erythrocyte counts and Hb values recover rapidly and by the sixth post partum week they reach close to the level of the control. 2) By the latter part of pregnancy both in multipara and primipara Hb values shew a marked decrease as compared with erythroyte count. Gradually presenting hypochromic-anemia picture, even in the sixth post partum week a delay in the recovery of Hb values can still be recognized, the delay being particularly striking in primipara. 3) It has been noticed that there is a greater tendency of delay in the recovery of Hb values along with increase in blood loss during delivery. Namely, though in the groups with blood loss of less than 10g./kg. at delivery the recovery of Hb values during puerperium is smooth and hematopoietic functions seem to be undisturbed. However, with increase in blood loss the recovery is proportionately delayed and in the groups with over 12.5 g./kg. loss a marked delay in the recovery of Hb has been recognized. 4) In primipara groups with under 7.5g./kg. blood loss and in multipara with under 12.5 g./kg. loss, the recovery of Hb values during puerperium is smooth; but in primipara with blood loss of over 10 g./kg. and in multipara with the loss of over 15 g./kg. the delay has been quite marked. In other words, in the groups with blood loss of over 7.5 g./kg. the rate of recovery in Hb values tends to be faster in multipara than in primipara. 5) Along with increase in the frequency of labor, the rates of increase have tended to increase by degrees.

An outbreak of encephalomeningomyelitis in Ehime·Syuso area from April to June 1956 was clinico-virologically investigated with the materials obtained from 28 hospitalized cases and their healthy visiting relatives. The major rise in polio type I antibody titer and the positive isolation of 4 strains of type I indicate the epidemy in this area to be the polio type 1. Three undeterminable cytopathogenic agents were concomitantly obtained in the HeLa cultures. The style of this episode was duly compared with the documents already reported.

In the observations of the pelvic nerves both in the reconstruction model of the pelvis of newborn and that of the extripated specimen after OKABAYASHI's hysterectomy as well as in the observations of pelvic nerves at autopsy, it has been verified that the vesical nerves are extensively extirpated and severed by the radical extensive hysterectomy for cancer of the uterus. Moreover, the micturitional functions after the disruption of communication with the center of micturition in the spinal cord seem to be undertaken by lower peripheral reflex arches located in the vesical wall and in the periurethral region. Therefore, for the recovery of postoperative urinary disturbances, systemic findings as well as findings on the vesical wall seem to be quite important.

In our country it has been believed that there is no histoplasmosis here in Japan. However, from the above clinical signs, radiological characteristics, laboratory tests, pathological and mycological examinations, and experimental findings, we believe this is the first case of histoplasmosis in Japan.

Tyrosine metabolism of toxohormone-treated mice and acatalasemic patient was not disturbed. These facts do not concur with the report of Zannoni and Bert who stated that catalase was an essential factor for the oxidation of p-hydroxyphenylpyruvic acid.

1. Quantitative examinations were made on the effect of benadryl and neoantergan on the histamine release in vitro from chopped skin of dogs and in vivo from rat skin. For estimation of the in vitro histamine release by biological method, a chemical procedure for separating the diffused-out histamine from mixed antihistamines was carried out. 2. Both antihistamines caused a fairly marked release of histamine from chopped skin tissues in comparatively higher concentrations. This action was synergistic with histamine-releasing effect of sinomenine and anaphylatoxin. 3. In lower concentrations, however, both antihistamines inhibited the in vitro histamine-releasing effect of sinomenine and anaphylatoxin. 4. Administration of a comparatively large amount of benadryl markedly depleted the skin histamine of a rat in vivo but smaller amount clearly suppressed the histamine depletion by subsequently administered sinomenine. 5. Based on the evidence of such dual action of antihistamines, some considerations were made on the site of action of these agents.

The process of hemoglobin sythesis in erythroid cells have been traced mainly by observing cells under the light of 4,060 Å. To scrutinize the theory of hemoglobin synthesis in the nucleus of erythroblasts, several cytochemical and morphological observations were also carried out. The conclusions derived from them are as follows: 1 The absorption at 4,060 Å of the cell, which indicates the location of heme, appeared in the nucleus as early as in the develpmental stage of basophilic erythroblasts. The absorption of hcme in cytoplasm likewise appeared in this stage showing nearly the same intensity of the absorption. The absorption picture of heme in the nucleus, which is coincidental with that of interchromatin, increased along with the progess of maturation as well as in the cytoplasm. The absorption in the nucleus disappeared at the orthochromatic stage where the picture of interchromatin disappeared, while the intensity of absorption in the cytoplasm continued to increase till the stage of reticulocyte. 2 The pseudoperoxidase reaction of hemoglobin, the appearance of acidophlic protein and masked lipids detectable in the location of hemoglobin gave an exactly identical picture with that of the absorption of heme in the nucleus as well as in the cytoplasm. 3 Permeability test performed by supravital staining with Nile blue revealed that the nucleus of erythroblasts from the basophilic to the orthorchromatic stages has increased its permeability being stained selectively as in the case of dead cells. 4 The mitochondria and the endoplasmic reticulum proved to be retained well in the entire course of hemoglobin synthesis, even after the denucleation, the reticulocyte stage. From these observations the authors believe that the hemoglobin syntheis will take place in the cytoplasm throughout the life cycle of erythroid cells, pointing out that the absorption picturebf heme appearing in the nucleus will be in all likelihood due to the infusion of the hemoglobin from the cytoplasm.

By prepariug over 100 thin slices from 77 cases of urinary calculi mainly consisted of vesical calculi and immersing them in various solvents, the solubility of these calculi has been examined by polarization microscopy from the standpoints of the composition and structure of urinary calculi. (1) MgNH4P04·6H20 (struvite) has been found to be most soluble and it is the best example in the dissolution of urinary calculi; and as for the solvents, Versene proved to be the best solvent. (2) The alkaline pH seems to have an intimate relationship with the dissolution of uric acid calculi. (3) Calcium oxalate proved to be insoluble in any solvent. In addition, no difference in its stability against solvents could be recognized in its monohydrate or dihydrate: (4) Cystine dissolved in the 10% Versene solution. (5) Amorphous-like substance apparently was dissolved slightly in 0.5% urease solution at 37°C, however, it is not possible to dissolve this substance completely, From these results calcium oxalate and amorphous-like substance seem to be the most difficult substances to dissolve, and therefore, the bearing they have on the dissolution of urinary calculi seems to most significant. In the present stage where little is known of real etiologic factors concerning the formation of urinary calculi, in the clinical application of the dissolution of stones further studies need to be carried on, but from the very nature of construction of urinary calculi, the local dissolution methods seem to be rather difficult at present, and rather somatic dissolution in connection with prophylaxis against recurrent stones seems to be the direction in which future studies need to be carried out.

The two rare cases with a high fever and anemia as the chief complaints were confirmed to be acute basophilic leukemia on the basis of the following findings, namely, 1) Numerous basophiloblasts and immature basophilocytes were found in the peripheral blood and bone marrow picture, but there were few neutrophils. 2) By the culture of bone marrow in cover-slips the growth type to acute leukemia, these basophilocytes appearing in the growth zone were clearly distinguishable from neutrophils, eosinophils or monocytes by the modus of their movement and cellular structure. 3) In vitro fluid medium culture revealed that blasts decreased in number along with lapse of time whereas immature and mature basophilocytes increased in inverse proportion. Having encountered these two rare cases of acute basophilic leukemia and being able to autopsy one of them, the authors report their case findings and confirm the distinction of basophiloblasts. Judging from these findings, the authors are of the opinion that some modification seems to be in the offering as regard the Naegeli's myeloblast theory.