Nagoya Journal of Medical Science

The therapeutic aspects of hemophilia were studied on a total of 22 cases, consisting of 13 hemophilia A, 8 hemophilia B and one with congenital combined deficiency of Factor V and Factor VIII.
1) The half life of the activity of Factor VIII following intravenous injection of fresh plasma, estimated 7 times in 4 cases, was ranged from 4 to 11 hours. Besides such short half life of Factor VIII, there appeared some cases with acquired resistance to transfusion efficacy after frequently repeated transfusions of blood or its preparation. Therefore blood transfusion should be avoided except when absolutely necessary.
2) Prednisolone and betamethasone were found to possess striking clinical efficacy in all of 9 cases with hemophilia, that was revealed by decrease in frequency of hemorrhage and by accelerated absorption of blood from hemorrhagic foci. But there found no case at all where activity of congenitally deficient clot- ting factor increased following their administration.
3) Antiplasmic substances, ε-ACA and trans-AMCHA, were also found to have such striking clinical efficacy as corticosteroids. In 15 out of 17 cases with hemophilia were found the decrease in frequency of hemorrhage, and the decrease of pain accompanying hemorrhage in all of 17 cases. Following the administration of antiplasmic substances in these hemophiliacs, the fibrinolytic activity of circulating blood and the inhibitor for formation of intrinsic thromboplastin were decreased, but in no case the activity of congenitally deficient clotting factor increased.
Based on the above results, it is concluded that antiplasmic substances and corticosteroids can be used extremely satisfactorily in the inhibition of hemorrhage in hemophilia.

In order to elucidate the factors which account for hemorrhagic diathesis of hemophilia, hemostatic studies were carried out in 55 hemophiliacs, consisting of 39 of hemophilia A and 16 of hemophilia B. These patients were classified into severe group (18 cases), moderate group (25 cases) and minimum group (12 cases), according to clinical severity without regard to the data of coagulation test. The results were summarized as follows;
1) The clinical severity in hemophilia did not necessarily coincide with data of coagulation test. Moreover, when hemostatic tests were conducted for pro- longed period on severe cases fluctuations were seen in their hemorrhagic mani- festations, but, during same observational period, there showed no variations in the grade of the amount of their congenitally deficient clotting factor.
2) On the other hand, changes in fibrinolytic activity of these hemophiliacs had a definite relationship not only with the grade of clinical severity but also the fluctuations of hemorrhagic manifestation.
Based on the above results, it became clear that the hemorrhagic disorders seen in hemophilia can be influenced by fluctuation in the fibrinolytic system.

This paper deals with electron microscopic changes in the acinar cells of the pancreas after the injection of antibiotics. Chloramphenicol and tetracycline therapeutic doses 25 mg/kg body weight/day respectively were administrated to guinea pigs for 10 or 20 days and the two same overdoses 250 mg/kg body weight/ day for 5 days. Pancreozymin 3 units/ kg body weight was administered singly or combined with chloramphenicol therapeutic dose and overdose. The changes found in these series with special emphasis upon zymogen granules, rough-surfaced endoplasmic reticulum, mitochondria and Golgi complex were compared.
The two antibiotics therapeutic dose series show some slight but not significant changes- in relation to rough·surfaced endoplasmic reticulum- in the acinar cells.
The two overdose series reveal different serious changes- a marked decrease in number and vacuolisation of zymogen granules, and a decrease in number of intracisternal granules and vesiculation of rough-surfaced endoplasmic reticulum, large vacuoles surrounded by mitochondria or by a single mitochondrion-like structure occur. The Golgi complex is somewhat dilated.
Pancreozymin singly induced accelerated secretion of zymogen granules and increase of dense material in the Golgi complex and intracisternal granules in the rough-surfaced endoplasmic reticulum, but pancreozymin combined with over dosed chloramphenicol does not turn the rough-surfaced endoplasmic reticulum disturbed.
By comparing these changes found in the different series, the role and significance of the organellae in the acinar cells are discussed in relation to secretion of the pancreas and enzymatic protein synthesis.