The incidence of malignancy and some of the problems of the clinical diagnosis of stomach cancer were examined in 751 autopsied cases of patients 60 years and over in Yokufu-En Geriatric Hospital from 1956 to 1963. In Yokufu-En, there is an old people's home and a geriatric hospital. 97% of the old people who are admitted to Yokufu-En spend all their remaining lives in this place and inmates of the old people's home who become ill, are admitted to the geriatric hospital; the average autopsy ratio during the past ten years in this hospital was 98.3%. 1. In the males, malignancy was found in 13.7% of the seventh decade, 19.5% of the eighth decade and 14.8% of the ninth decade and over, and in the females, 12.7%, 11.4% and 11.3% respectively. 2. Among the malignancies, stomach cancer was found most frequently (48%), followed by lung cancer (14.7%) and cancer of the gallbladder (7.8%). 3. In 18 of 49 cases, the clinical diagnosis of stomach cancer which was proven at autopsy was impossible, when the patient was alive. It was not easy to make clinical diagnosis of stomach cancer in the aged, when the patient had several chronic diseases and had been confined to bed for a long time, for, in such a patient, we often encountered difficulty in the X-ray examination of the stomach. 4. According to the statistics of the causes of death in Japan, malignancy forms 9.5% of the causes of death in the 75-79 age group, 5% in the 80 years and over, and senility forms 12.5%, 28.5% respectively; in the 80 years and over it is the most frequent cause. However, from the statistics of malignancy in this study and from other studies of the causes of death in the aged, it is suggested that among those, whose cause of death is attributed to senility in Japan, there may be a considerable numbers of undiagnosed malignancy.
The 182 patients in the KAKEYU balneo-therapeutic institute and clinic were investigated by examination and questionnaire to find out the relationship between cerebrovascular lesions and speech disorders. The results obtained are summarized as follows. 1. Ninty-seven (52%) out of 187 patients showed some symptoms of speech disorders at the onset of the disease. These were aphasia 24, dysarthria 39, aphasia and dysarthria 15, and unknown 19. 2. Seventy-seven per cent of the patients with motor and sensory disturbance on the right side had speech disorders, while only 28% of the case on the left side showed speech disorders. 3. Those cases with motor and sensory disturbance on the left side had a tendency toward earlier recovery of speech disorders than those on the right. 4. Dysarthria was mainly found among the patients who had dysphagia and impediments in the upper limb and face. 5. Aphasia were found mostly among the patients who had motor and sensory disturbance on the right side. 6. The possible relationship between cerebral dominance and handedness was not clear, because the number of the patients of left handedness and ambidextrous handedness were not sufficient in the present study.
Clinicopathological study was carried out to examine the pathogenic relationship between pulmonary tuberculosis and emphysema in 70 cases of aged pulmonary tuberculosis in the Yokufukai Hospital. 1. No marked differences were observed in the morphological types of emphysema between the cases with and without tuberculosis. The uneveness of emphysematous changes in the different part of the lung, however, was more marked in the cases with pulmonary emphysema complicated by tuberculosis than in the cases with pulmonary emphysema alone. In the former group, emphysematous changes were seen markedly in the segment where tuberculous foci were presant. These results suggested that the tuberculosis has a local effect upon the pathogenesis of pulmonary emphysema. 2. The rate of the developement of pulmonary emphysema among the aged tuberculous patients was slightly higher than the incidence of pulmonary emphysema among the aged. In tuberculosis, following clinical factors such as the age, severity of tuberculosis, clinical course of tuberculosis, existence of cavity and the positiveness of tubercle bacilli in the sputum showed no influences on the development of pulmonary emphysema, while the patients with cough and sputum were more likely to be complicated by emphysema.
By direct measurement on the roentgenograms and densitometry in comparison with aluminum step-wedge, all metacarpals of both hands were studied. Thickness of the cortex declined with advancing age especially in females after middle age so that a significant difference between males and females was obtained after the age of 60. The decrease in cortical thickness was especially pronounced in the first and fifth metacarpals resulting in a highly significant correlation between age and peripheral-central ratio of the cortical thickness in both sexes. The density of metacarpals was definitely lower in females than in males above the age of 30, indicating the earlier onset of the decrease in density than that of the thinning of the cortex. A negative correlation was found between age and metacarpal density in females but not in males.