PSP Test Research Articles

The post-installed screw pull-out test: Development of a method for assessing in-situ concrete compressive strength

In concrete structures, the current methodology for concrete strength estimation combines the use of in-situ test methods with destructive techniques (taking cores). In-situ tests are indirect approaches, and can be affected by several uncontrolled factors, thus inducing uncertainty in the strength estimate. Low cost in-situ methods are often deployed in practice, without taking due consideration of the low reliability. Thus, the reliability of the estimated concrete strength is always a questionable issue. In this context, this paper seeks to develop an in-situ test method as an alternative to the available techniques to assess in-situ compressive strength of concrete. The PSP test is proposed based on the modified pullout testing of post-installed screw. The test is a partially destructive technique that involves insertion of an oversized screw into a predrilled hole in the hardened concrete and subsequent pullout of the screw compelling the concrete to follow a specific failure pattern – a complete pullout failure. The peak load obtained in the process is then correlated to the concrete compressive strength. In determining an appropriate and robust configuration for the PSP test, commercially available screws of different sizes were investigated along with different sizes of drilled hole. High strength correlation of the PSP test in mortar with selected test configuration reveals the potential of the test to be used in the strength assessment. Further investigations are proposed to confirm the suitability of the test to be applied in concrete.

PHYTOPLANKTON SPECIES COMPOSITION IN SEAWATER AND TISSUE OF GREEN MUSSELS (PERNA VIRIDIS), AT KALI BARU-CILINCING, NORTH JAKARTA

Species composition and abundances of phytoplankton in the shellfish farming area in Jakarta Bay, Kali Baru-Cilincing, were examined in order to identify harmful algae species. Phytoplankton contained in the shellfish was also observed to detect the presence of toxic species, as well as the phycotoxin contained in visceral of green mussel (Perna viridis) collected from the farming area using brine shrimp lethality test (BSLT). We detected the presence of Alexandrium spp. (PSP causing species), Dinophysis caudata, D. miles and D. rotundata (DSP causing species), and Pseudo-nitzschia spp. (ASP causing species). The last mentioned species was also detected in thestomach content of green mussel. The toxicity of green mussels tested was recorded LC 50 ≤ 1,000 ppm and indicatedthe presence of an active compound in the green mussel viscera. Meanwhile, preliminary PSP test of shellfish did not showed any toxin.

Operational application of a rapid antibody-based detection assay for first line screening of paralytic shellfish toxins in shellfish

Paralytic shellfish poisoning toxins (PSP-toxins) are potent neurotoxins associated with marine dinoflagellates and may accumulate in filter-feeding shellfish to cause food intoxication in human. Monitoring programs for PSP in shellfish rely heavily on the use of traditional mouse bioassay (MBA). Considerable progress has been made in developing a reliable, rapid and relatively convenient assay for mass screening of possible PSP contaminated samples. In this study, we investigated the potential application of a commercially available antibody-based assay for routine first line screening of PSP-toxins in shellfish collected in Hong Kong. Preliminary study showed that the Jellett Rapid PSP Test (JRPT) performed acceptably in detecting regulatory limit (80 μg STXeq per 100 g of shellfish tissue) of each standard toxin under shellfish matrix mediums and human urine, except GTX1,4 and NEO. The results indicated its potential applicability in field and outbreak situations. Upon applying the kits in 938 field samples for over 2 years, no false JRPT-positive result was determined from MBA-positive samples. However, JRPT was able to detect MBA false negative sample that exceeded the regulatory limit as determined by High Performance Liquid Chromatography (HPLC). On the other hand, a number of JRPT false positive results were revealed, based on HPLC data, suggesting that the effective or actual limit of detection for JRPT was less than 40 μg STXeq per 100 g of shellfish tissue. Of all MBA-JRPT-negative samples, 21% showed HPLC-positive results. Nevertheless, the PSP toxicity levels were below the limit. No false JRPT-negative result was found during the study. This indicated its potential efficacy for use as screening assay from public health perspective. HPLC analysis showed that STX, NEO, GTX2,3 and GTX5 were the most common PSP-toxins found in shellfish. The PSP-toxins profile and their relative abundance in shellfish were demonstrated to be potentially good biochemical markers for investigating and tracing the samples’ origin. In addition, 11% of samples were recorded as JRPT-invalid results, in which 78% came from oysters. Treatment of these JRPT-invalid samples by a centrifugation step followed by a centrifugal filtration was very effective (95% validity with clearer indication lines after reanalysis by JRPT) in reducing invalid results through removing potential interfering substance(s) in shellfish matrix. Complementary to MBA and HPLC toxins analysis, JRPT was shown to be an appropriate tool for rapid and mass screening of potential PSP-toxins contaminated shellfish. When public health actions are considered to verify JRPT-positive, HPLC-positive and uncertain cases samples, confirmatory test should be performed by gold method, MBA.

Effect of steam cooking on distribution of paralytic shellfish toxins in different tissue compartments of scallops Patinopecten yessoensis

This study investigated the effect of steam cooking on distribution of paralytic shellfish poisoning toxins (PSP-toxins) in scallops Patinopecten yessoensis. Toxins analysis by high-performance liquid chromatography showed that most of the PSP-toxins (>70%) were accumulated in viscera and adductor muscle of the raw scallops. Steam cooking induced significant loss ( p < 0.05) of PSP-toxins from viscera (16%), adductor muscle (24%), gill and mantle (11%) while 32% of the toxins were retained inside viscera and adductor muscle. Overall, 51% of PSP-toxins leaked out from scallop tissues during steam cooking. However, there was no significant loss ( p > 0.05) of PSP-toxins from gonad. Consumption of viscera was the most significant risk factor for causing PSP, while gonad and scallop soup were the second most significant. A rapid PSP test further verified detectable levels of PSP-toxins in all samples. However, possible interfering substance(s) in adductor muscles and gonads might potentially affect the results from this test.

Clinical Usefulness of the Dye‐Injection Method for Diagnosing Premature Rupture of the Membranes in Equivocal Cases

In 1981, we preliminarily reported on the clinical value and safety of the intra-amniotic dye (Phenol-sulfonphthalein, PSP)-injection method for diagnosing PROM. In the current study, through examination of 64 equivocal cases in the midtrimester of pregnancy, we investigated the clinical efficacy of the PSP test. In the present study we examined patients with equivocal PROM in their 14th week to 33rd week of gestation, whose findings were positive according to a combination of conventional diagnostic methods. The results of the PSP test and conventional diagnostic methods were compared with the final diagnosis of PROM. The conventional diagnostic methods showed an accuracy rate of 63.9%-70.5%, in contrast to the PSP test, which had a 100%-accuracy rate (p < 0.001). Using the PSP test in combination with amnioscopy, we have established a method of differentially diagnosing PROM. We have reconfirmed the clinical efficacy of the PSP test in 64 equivocal PROM cases.

TREATMENT AND PROBLEMS OF AGED PATIENTS OVER 80 YEARS OLD WITH GASTRIC CANCER

Among patients with gastric cancer experienced at the department from January 1980 to December 1991, 30 patients over 80 years of age were subjected to this retrospective study. Macroscopic findings showed that half of their cancers were located in the upper part of the stomach, and over 70% of the cancers were tumorous or expanding types (Bormann type 2 or 3). Histologic findings indicated that 80% of the cancers were well or moderately differentiated adenocarcinomas, and lymph node metastasis was mostly limited in the local area (n0 or n1). The aged patients had multiple dysfunctions in the preoperative examinations shown by ECG, respiratory function, PSP test, serum protein and hematocrit, and postoperative complications including anastomotic leakage, stenosis and respiratory complications frequently occurred compared to the younger patients under 80 years of age. The long-term prognosis was not significantly lower than younger patients in 5 years after the operation, if the curative operation could be done. In the treatment of aged patients with gastric cancer, we strive for curative resection with R2 lymph node dissection basically, however, the avoidance of postoperative complication by diminished operation with R1 or R0 is important for patients whose preoperative examinations indicate multiple organ dysfunction.

海綿腎の臨床的検討

Thirty eight patients with medullary sponge kidney (MSK) were detected (4.3%) in 881 patients with urolithiasis diagnosed by drip infusion pyelography in 12 years from January 1974 to December 1985. Those with MSK were studied clinically and as to metabolism of urolithiasis. The results obtained were as follows: 1) Age distribution of the patients with MSK was the same as that of general stone formers. 2) Hematuria was observed in 20 patients (52.6%) and pyuria in 7, in whom 4 were positive by urine culture (E. coli in 3 and P. mirabilis in 1) and 2 of them had infective stones. 3) Renal function of the patients examined by PSP test (20 patients) and creatinine clearance test (21 patients) was normal in all of the patients but three with ureteral caliculi. Concentration tests performed by Fishberg method (12 patients) were disturbed in half of them. 4) Affected lesions wer detected at more than three pyramides in each kidney and the bilaterals were found in 32 patients (84.2%) and at less than two pyramides in each kidney and the unilateral or the bilaterals were shown in the other 6. 5) When urinary levels of calcium, phosphate, uric acid and citrate using 24 hours urine were compared with 37 patients with MSK and 100 general stone formers, there was no difference in hypercalciuria and hyperuricosuria accounting for the frequency of the patients with MSK and the general stone formers, but there was a tendency of increased frequency about hyperphosphaturia and hypocitraturia in the patients with MSK.(ABSTRACT TRUNCATED AT 250 WORDS)

A method for estimating renal functions based on the radioisotope renogram

A method has been developed to predict or estimate the results of commonly used routine renal function tests based on a renogram. The model is built on two differential equations derived in terms of seven parameters which can be measured from tracings of radioactivity recorded on the heart, the kidneys, and the bladder. The model successfully reconstructed every possible variation of the renogram pattern by computer simulation. Expected results of the four renal function tests were computed by multiple regression equations using five out of the seven parameters as criteria variables ( p < 0.05). The four renal function tests were (1) a concentration test, (2) a PSP test, (3) the glomerular filtration rate, and (4) blood urea nitrogen.

A case of Sjögren Syndrome associated with Basedow's Disease and Latent Renal Tubular Acidosis

A rare association of Sjogren syndrome, Basedow's disease and latent renal tubular acidosis occurred in 46-year-old female. She has been suffered from thirst, and generized sweating during the last several years. On August, 1978, she felt dull pains on both lower extremities and the cuccyx, and so she consulted a home-doctor. Taxing the drugs, she felt palpitation. On October, she was pointed out having dry eye and dry mouth. On admission, she was somewhat nervous. Pulse rate was 104 per minutes, and blood pressure was 164-85. Diffuse goiter without exophthalmos was possitive. Hepatosplenomegaly was negative. Bilateral hand finger tremor was positive. Laboratory data included polyclonal hypergammerglobulinemia, slightly microcytic hypochromic anemia, normal liver function tests, and normal values of BUN, cleatinine, PSP test, Fishberg concentration test, cleatinine clearance and electrolytes. PH in artery blood gas was 7.415. There were positive for anti-DNA antibody (RIA), anti-RNP antibody, anti-Sm antibody, anti-thyroglobulin antibody, and anti-microsome antibody. But RA factor, LE cell, and BFP were negative. Schirmer test and Gum test were abnormal. Sialography showed abnormal shadow of apple tree patterns. Lip biopsy demonstrated chronic sialadenitis. NH4Cl loading test showed latent renal tubular acidosis of distal type. Chest X-P showed interstional fibrosis. Thyroid gland function tests showed hyperthyroid. Thyroid gland biopsy showed that flat and cube-like follicules of various size filled almostly with colloid, where slightly papillary epithelial proliferation were seen. Thyroid function was normalized after Propranol-HCI and Thiamazole administration. Although chronic thyroiditis was associated with about 10% of cases with Sjogren syndrome, the combination of Basedow's disease, latent renal tubular acidosis and Sjogren syndrome has been rarely reported. The speculative pathogenesis and the clinical problems were discussed.

RENAL GLOMERULAR CHANGES ASSOCIATED WITH LIVER CIRRHOSIS

Renal glomerular changes associated with 79 liver cirrhosis cases were studied by light and electron microscopy, and immunofluorescent methods. The glomerular changes were classified as follows: 1) Mixed membranous and proliferative glomerulonephritis type having subepithelial, subendothelial, mesangial and paramesangial deposits (37 cases), 2) membranous glomerulonephropathy type (6 cases), 3) IgA nephropathy type (3 cases), and 4) glomerulosclerosis types (5 cases). Clinically, the patients with marked renal glomerular changes and proteinuria, hematuria, and retention by the PSP test. It was suggested that the essential renal glomerular changes in liver cirrhosis was immune-complex mediated glomerulonephritis and that glomerular sclerosis was merely a secondary change to glomerulonephritis.

Influences of Long-term Tolbutamide Administration on Diabetic Syndrome in Alloxan Rabbits

The present experiments were designed to study the effects of prolonged tolbu-tamide (Tolb) administration on diabetic symptoms, using alloxan rabbits as model. Eighty seven diabetic rabbits obtained by the intravenous injection of 100-130mg/kg of alloxan monohydrate were divided into three groups-untreated control, Tolb 100 mg/kg treated group and Tolb 200mg/kg treated group. Tolb was given consecutively for 3 and 6 months, and during these periods, body weight, morning blood glucose and the daily amount of urinary sugar were measured. And also ECG recording, PSP excretion test and ophtalmologic test were performed. During the 6 months period, body weight tended to increase and blood glucose and urinary sugar tended to diminish gradually, but there was no difference in death rate among the three groups.As for ECG, bradycardia and abnormal ST-T were observed in several alloxanized rabbits, and in the Tolb treated groups their incidences were significantly increased. As for PSP test, no abnormal values were obtained from the alloxanized animals, and also no effect of Tolb was found.The longer the expeimental course, the number of incidence of cataract was found to become higher. But neither retinal vessel alteration nor other pathological changes were observed in the alloxan animals, with no difference observed between the control and the treated group.

腎切石術における腎実質縫合法の研究

The author made a study on the renal vascular pattern and the renal function before and after operation of staghorn calculi or multiple large calculi in 17 kidneys of 16 patients.The cases were divided into the following 2 groups. Group I (14 kidneys of 13 patients) were subjected nephrolithotomy. Group II (3 kidneys of 3 patients) were subjected to partial nephrectomy.In nephrolithotomy, closure of the renal parenchymal incision was made with one layer interrupted suture from pelvic mucosa to renal capsule by 2-0 plain cat gut. This method was originally designed by Dr. Taguchi in 1967 and he had performed the operation by this method in about 50 cases with good result.Renal angiography was performed in 12 kidneys of Group I and 2 kidneys of Group II.The renal function was assessed by BUN, serum creatinine, PSP test, Fishberg's concentration, renal clearance (24-hour creatinine clearance), excretory urography and isotope renogram.The following conclusions were obtained.1. The average duration of renal artery clamp time of Group I was 16 minutes and 14 seconds and shorter than that of Group II.2. Preoperative angiograms were classified into 3 patterns. They were compatible with normal, pyelonephritis and hydronephrosis.3. Postoperative angiograms of Group I showed the interruption of interlobar arteries in 91.7 per cent of kidneys. Cortical infarction due to arterial interruption was seen in 66.7 per cent of kidneys but the mean residual area of nephrogram in these 8 kidneys was 93.6 per cent of that found in the preoperative examination. The mean diameter of the renal main artery was 87.5 per cent of that found in the preoperative angiograms and arterio-venous fistula was proved in one case without any circulatory complications.4. Renal function of Group I has improved or remained stable postoperatively in all but 2 patients whose isotope renogram was slightly deteriorated.5. In Group II, there were arterial spasm in residual renal parenchyma and the mean diameter of the renal main artery was 69.0 per cent of that found in the preoperative studies.6. Renal function of Group II by excretory urography and isotope renogram showed a reduction in 66.6 per cent of kidneys but the other function tests remained unchanged.7. Despite the limited number of cases treated and the short period of follow-up, it is considered that the parenchymal loss and arterial damage are of little importance in nephrolithotomy with one layer interrupted suture. This result was due to the short arterial clamp time and harmlessness of parenchymal suture.

Prediction of the effect of corticosteroid on idiopathic nephrotic syndrome based on a discriminant function.

For the purpose of discriminating between cases of nephrotic syndrome with and without corticosteroid effect, a linear discriminant function was applied in attempt to predict the effect of corticosteroid by the use of a computer. The parameters used were 15-min values of the PSP test, urinary protein, serum cholesterol, renal biospy findings, the number of red cells in the urinary sediment and immunoglobulin clearance ratio. The rate of correct prediction using the function with immunoglobulin clearance ratio was 87.0 %.

Resection of the vena cava for renal cell carcinoma: experimental studies on renoportal venous anastomosis (author's transl)

The renal cell carcinoma often involves directly the inferior vena cava. The method of the curative treatment for such a case is radical nephrectomy with en bloc resection of the inferior vena cava containing tumor. However, excision of the vena cava extends above the contralateral renal vein, results in passive renal congestion and failure when adequate venous collaterals are not developed.As one of the surgical methods to cure completely such a case without injuring the function of the remaining kidney, we studied on an resection of the inferior vena cava and on an end-to-side renoportal venous anastomosis.Using 7 mongrel adult dogs, we resected the left kidney and the inferior vena cava en bloc from above the left suprarenal vein to just above the iliac bifurcation, and made an end-to-side anastomosis between the right renal vein and the portal vein. At the same time, we ligated and divided the left spermatic (or ovarian) vein emptying to the left renal vein, the lumbar vein, the left suprarenal vein and the right spermatic (or ovarian) vein entering the resected vena cava.Five of these 7 dogs maintained excellent health and were followed up for 12 to 14 months. Two dogs died of bleeding and shock, 6 hours and 17 hours after the operation respectively.Renal and liver functions of the 5 dogs were examined for 12 to 14 months after operation. The examinations proved that the renal functions (blood urea nitrogen, serum creatinine level, PSP test and excretory pyelography) were normal and proteinuria was negative. In addition microangiogram revealed no irregularity in the vascular system of the kidney and histological examination disclosed that glomeruli and renal tubules were normal.As liver function tests, alkaline phosphatase, bilirubin, GOT, GPT, and LDH were determined and they were all found normal. Also, histological tests revealed that the liver was normal.Concerning the collateral blood flow after excision of the inferior vena cava, the vertebral vein, azygos vein, hemiazygos vein, lumbar vein, deep iliac circumflex vein and right suprarenal vein were examined.Judging from above findings, we consider our method worthy to apply to selected patients, as one of the curative treatments for the renal cell carcinoma which involves the inferior vena cava.

膀胱拡大術の臨床研究

Our cystoplasty regenerates and expands the bladder as performed and reported in a case report by the authors in “A Study on Cystoplasty by Regeneration of Contracted Bladder using Novectane (Liquid Synthetic Resin)-sprayed Thin Paper (1)”.This first case has been under postoperative clinical observation for more than two years and a half. The fact that the bladder capacity has increased from 50-60cc before the operation to 400cc and the residual urine is less than 10cc indicates long-lasting very favorable results of cystoplasty. Even 2 years after the cystoplasty it was not possible to discriminate the regenerated bladder wall from the original bladder wall under the cystoscopic examination. Both urine analysis and cystogram indicate a normal state.Case 1 has becomes the basis for further cystoplasty being performed by the author, H. Taguchi. Two additional clinical cases with more complicated conditions than Case 1 are reported below.Preoperative condition and Surgical Method:Case 2 is a 24 year old female. About 10 years ago she underwent nephrectomy of the right kidney because of kidney tuberculosis. Her main complaint was two-stage urination and micturition accompanied by a continuous sensation of residual urine. The PSP test by insertion of the Nelaton catheter gave a 15 minute value of 30% and a 2 hour value of 75%. Fig. 1 (1), (2) indicates the retrograde cystograms prior to the operation.Fig. 1. (1) shows bladder form after infusion of 60 cc contrast media.Fig. 1. (2) shows bladder form after infusion of about 200cc at maximum desire to urinate.Almost all cystograms indicated the same bladder shadows. Vesico-ureteral reflux was recognized reaching as far as the renal pelvis. Hydronephrosis was evident and the ureter was enlarged. The bladder capacity was less than 20cc.According to the pathological conditions of the subjects two different operations were applied. One operation (A) was performed to prevent vesico-ureteral reflux and consisted of triangular flap method, 2) according to which ureter was anastomosed to the original bladder. The other, operation (B), was aimed to increase the capacity of the bladder content and composed of cystoplasty, which was performed in the same method as in Case 1 by using an artificial bladder prepared from Novectanesprayed thin paper.Case 3 is a 50 year-old female. About 3 years ago she underwent nephrectomy of the right kidney because of kidney tuberculosis. And about 2 years ago she underwent nephrostomy of the left kidney because of a stricture in the lower end of the left ureter. Therefore, for more than a year, the bladder had not been used.Fig. 3 shows a pyelogram (pyelo-ureterogram), in which contrast media was injected from nephrostomy, and a retrograde cystogi am taken before operation. The lower end of the ureter is completely closed ey a stricture. The cystogram was taken at maximum desire to urinate and the bladder capacity was about 50cc. This patient visited our hospital because of urgent desire to urina te from the normal urethra. However, the PSP test revealed an unfavorable condition as with a 15 minute value of 5-10% and 2 hour value of 30-40%. Cystoplasty was performed in Case 3 by the same method as (A) and (B) of Case 2.The operation time was less than 2 hours in all three cases. The operation was performed under spinal anesthesia in Case 1, which was comparatively simple, and in Case 3 with lowered kidney function. The operation in Case 2 was performed under general anesthesia by tracheal insertion.In addition, bladder inflammation of these 3 cases were remedied before operation.Post-operative Observations:As in Case 1, in both Cases 2 and 3, the artificial bladder, in an utterly unchanged state, fell off completely within the bladder in about 3 weeks, concurrent with the completion of the granulation wall of the regenerated bladder1). It was possible to completely extirpate the

The sixty-minute plasma phenolsulfonphthalein concentration as a test of renal function.

A study of 56 patients showed that the concentration of phenolsulfonphthalein in plasma 60 min. after the injection of 1 mg. per kg. of body weight (PSP60) is a reliable indicator of the degree of renal function, and more accurate than serum creatinine values when the latter are not appreciably elevated. In patients with serum creatinine values <4 mg. per 100 ml., correlation coefficients of the PSP60 with both creatinine clearance and values for the urinary PSP test were 0.90 in each instance. PSP was determined colorimetrically after extraction with acetone and alkalinization. It is suggested that the PSP60 will probably be of most value in patients with at least one-third of their normal renal function who have urologic problems which make complete collection of urine difficult or who are unable to cooperate. It may also prove useful as a screening test for abnormalities in renal function.

Clinical significance of the fetal PSP test.

The authors studied a clinical value of the fetal PSP test reported in the previous paper. The low level in the fetal PSP test was defined to be below 15% in three-hour excretion rate. The low excretion of PSP was found in about onehalf of the postdate group and of the toxemia group. About 40% of cases with the low excretion rate of PSP showed the low urinary estriol level below 10mg/day by Kambegawa's method. Close relation was recognized between the low value of the PSP test and other several factors concerning the placental permeability; such as the low placental-fetal weight ratio below 0.15, the existence of calcification and white infarct in the placenta, and the histo-pathologic findings of the placenta. Intrauterine fetal distress and neonatal asphyxia were also found more frequently in the group of low PSP excretion than in the normal group. The authors believe that the fetal PSP test is a safe and valuable method in estimating the permeability funetion of the placenta of late pregnancy.1. The authors devised a method to examine permeability function of the placenta by injection of PSP into the fetus. The normal excretion rate in maternal urine was defined to be more than 16% per three hours.2. The coincidence rate between the fetal PSP test and the urinary estriol was about 42%.3. Close relation was recognized among the result of the fetal PSP test, histologic findings of the placenta, such as calcification, infarct and other histologic findings, and placental-fetal weight ratio.4. Intrauterine fetal distress in partu and neonatal asphyxia were found more frequently in the group of low PSP excretion.5. Low PSP excretion below 15% per three hours was found in 57% of cases with prolonged pregnancy and in 52% of cases with toxemia of pregnancy.6. The authors believe that the fetal PSP test is a simple and safe test for permeability function of the placenta.

Experimental Studies on a New Test for Placental Permeability by Phenolsulfonphthalein Injection to the Fetus (Fetal PSP Test)

The authors devised a new diagnostic method of placental permeability by transabdominal injection of PSP into the fetus, and named it ‘fetal PSP test’. In normal full term pregnancy, the excretion of PSP into maternal urine began within 30 minutes after the PSP injection and reached the maximum in 90-120 minutes. The normal value was decided to be more than 16% in total excretion rate for 3 hours. Although the fetal PSP test way considered to be influenced by uterol placental irculation, maternal renal function and other factors of the fetus and mother, a certain parallelism was found between the clinical results and the data obtained from perfusion study by using the delivered placenta.

Revised PSP Test for Tubal Patency

Revised PSP Test for Tubal Patency

Studies on the brain and bladder. 1. Clinical and experimental studies on minamata disease

Minamata disease which broke out on the coast of Minamata, a southern city in Japan, from 1955 to 1959, was a disorder of the central nervous system. It was proved that the cause of this disease was methyl mercuric compound which was taken from fishes or shellfishes contaminated by an effluent from a chemical plant. There have been many clinical and pathological reports on this disease. However, up to today, there have been no observations on the function of the urinary tract in this disease. The purpose of the present report is to research into the renal and vesical functions in Minamata disease.Examinations were made in 33 cases of Minamata disease, including neurological examination, electroencephalography, renal clearance test, PSP test, Fishberg's concentration test, blood chemistry, urine examination, IVP, cystography and cystometry. As controls, renal function and cystometrogram in 15 rabbits of ethyl mercuric phosphate poisoning and cystometrogram in 21 cases of brain diseases were studied.The following results were obtained.1) Neurological examination and electroencephalography revealed that, the chiefly disturbed portions in Minamata disease were the cerebral cortex and cerebellum. In the cerebral cortex, the chief lesions involved covered Sulcus calcalinus and Gyrus centralis in adult cases. In children, especially in congenital cases, involvement is extended wider to the frontal lobe.2) A majority of cases of Minamata disease showed normal renal function, while some showed moderate disturbance of RPF and proximal tubular function.3) Hypertonic small bladder was observed in 4 of 14 adult cases of Minamata disease, in 5 of 7 child cases and in 11 of 12 congenital cases. On the other hand, 3 of 14 adult cases showed a normotonic or hypotonic large bladder. Efficiency of micturition was generally good. Urinary incontinence was observed in only 3 congenital cases.4) Six rabbits which were given 2mg per kg of body weight of ethyl mercuric phosphate every other day developed moderate disturbance of renal function; and 9 rabbits, which were given 4mg per kg of body weight every day showed severe disturbance of that at the time of development of Minamata-disease-like symptoms. Some of these rabbits showed hypertonic small bladder, while some others showed large bladder.5) A large number of cases of either cerebral arteriosclerosis or frontal lobe tumor showed a hypertonic bladder, on the other hand, almost all cases of traumatic epidural hematoma showed a hypotonic bladder.The above results show that organic mercuric compounds have direct poisoning effect on the kidney, but in Mimanata disease, the disturbance of renal function was very rare. The results also suggest that there may be two centers which control the urinary bladder. One is the suppression certer which might be situated in the frontal part of the frontal lobe and the other is the promotion center situated behind the former.