Through this experiment an observation was made on the changing blood pictures of forty healthy male-employees at the Tokyo First National Hospital who were given Influenza A '57 vaccination.
Before vaccination and 48 hours and 10 days after vaccination, the W. B. C. was found to be unchanged. Both monocytes and eosinophils slightly increased in number while neutrophils decreased slightly. No apparent change in number of lymphocytes was noted. However, atypical lymphocytes was found in 29 cases out of 39 but this phenomenon showed no relationship with either increase or decrease in number of lymphocytes.
No significant relationship was noticed among the following three factors: number of lymphocytes, atypical lymphocytes, and hemoagultinating inhibition antibody.

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Nobi-fever or Miura-fever, a feverous and exanthematous disease has been recently determined by us to be a variety of Tsutsugamushi disease. It is in it's clinical and epidemiological characteristics very similar to Shichito-fever (Tsutsugamushi disease) and to Tsutsugamushi disease found in the Boso-and Izu-peninsula area.
The authors treated 67 cases and a detailed report is made on 5 cases with typical forms.
In blood of the first two patients “Rickettsia tsutsugamushi” was detected and the same was found in blood of field mice which was caught near the residence of the third patient.
Although we were not able to find evidence of Rickettsia tsutsugamushi in blood of the forth and fifth patients, the cases were typical Tsutsugamushi disease from a clinical and epidemiological point of view.
In April 1958 at the General Meeting of the Japanese Association for Infectious Diseases a summary of this report was submitted verbally.

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One hundred and twelve stocks of coagulase-positive staphylococcus aureus were isolated from the nasal mucous membrane of (a) hospitalized tuberculous patients, (b) nurses, (c) pupiles of middle and primary school in Onohara village where there is no hospital or infirmary, and (d) out-patients to ous hospital. Sensitivity of the stocks to antibiotic drugs and sulfonamides was studied.
The sensitivity to penicillin did not differ in the four groups. Biographically, sensitivity of staphylococci from hospitalized patients to penicillin is said to be lower than that from the out-siders because of the frequent use of antibiotic agents of the former. Our result suggest that there is a limit in the acquirement of resistance and all the four groups have almost reached this limit.
The sensitivity to streptomycin is high in group (a), (b), (c) and (d) in the increasing order, the difference being significant.
This phenomenon is similar to that in the course of resistance-acquirement to penicillin. The resistance to streptomycin will keep increasing in future as it is to penicillin.
Mechanism in the resistance-acquirement of staphylococcus to streptomycin in our hospital was investigated. Use of streptomycin for other diseases than tuberculosis was very seldom, while the number of streptomycin-resistant cocci in our hospital increased considerably in the period of 1955 and 1957.
And streptomycin-resistant cocci were found more frequently in the hospitalized tuberculous patients than in stocks from nurses. It is supposed, therefore, resistancc acquiement of staphylococci to streptomycin in our hospital is due to the use of streptomycin in tuberculous patients.
The sensitivity to tetracyclin, erythromycin and chioramphenicol did not differ in the four groups. This may be because these drugs are not widely used so that resistance to them has not developed yet.
The sensitivity to sulfisoxazol is high in group (b), (c) and (d) in the increasing order. This again is similar to the case of penicillin and the resistance will increase in future.
The sensitivity of the staphylococcus in this district was compared with stocks of Dr. Nagai of Tokyo University. There was no difference in sensitivity of these two to penicillin, chloramphenicol, tetracyclin, erythromycin and sulfonamide. However, sensitivity of staphylococci of this district to streptomycin is markedly higher than those of Dr. Nagai.

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Tests on the liver functions of 26 patients hospitalized at Setagaya National Hospital were carried out before, during, and after surgical operations under general anaesthesia.
Results are as follow:
1) Liver functions such as Takada reaction, C. C. F., total serum bilirubin, B. S. P., serum alkaline phosphatase, and A/G ratio became worse by the administrations of ether and Cyclopropane for a while and recovered slowly with time. There were difference in the grade of tests results between the patients with diseased liver and the patients with normal liver. Whereas in the latter cases liver function recovered almost to normal level after 3-5 days, patients with slightly or moderately disturbed livers recovered after 7-14 days. Patients with seriously damaged liver were very slow in recovery and in some cases no sign of recovery could be observed after 2 weeks.
2) The complications of inhalation anaesthesia occur often in the patients with liver disease so that some of the patients with such affection have to avoid not only operation but also the general anaesthesia. In some cases, hypothermia might de necessary.
3) General anaesthesia should be carefully administered for those patients who have liver disease. Good nutrition and ample supply of oxygen are also necessary for the protection of liver from damage.
4) B. S. P., serum alkaline phosphatase and A/G indicate the status of liver function rather well and therefore can be utilized for testing liver function. However, the liver function as a whole can only be judged by the comprehensive review of repeated tests and by use of clinical judgement.

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As combined chemotherapy for pulmonary tuberculosis two-drug therapy employing SM intermittently and PAS daily has been used universally, but recently the effects of this two drug regimen became a subject of discussion.
Especially in comparison with the method of so-called “Japanese combined therapy” administering PAS daily, SM and INH twice a week, on which Prof. T. Kumagai and his coworkers have been advocated, we can confirm clearly superiority of the latter to the former.
Since July 1953 this Japanese combined therapy has been applicated in our hospital to over 1, 000 pulmonary tuberculosis cases and proved the superiority of this method.
Although some authers maintain that large dose of INH daily is more effective as the intermittent administration. This problem must be studied in future.
Among 58 cases of pulmonary tuberculosis treated with chemotherapy, 27 cases were treated with Japanese tripple drug chemotherapy, and SM twice a week and PAS daily were administered to 31 cases. In these cases, we observed change of cavities on roentogenograin, conversion of sputum for tubercle bacilli, and bronchographic findings of drainage bronchi every 6 months following the course.
The difference of two groups are as follows:
1) Cicatrix or cavitary closure occurred in 66.6% of the group which has been treated with tripple drug combined therapy, on the contraly favorable change of cavitary shadows was seen in only 9.8% of the group which has been treated with SM and PAS.
Indeed in 77.5% of this group occurred diminution or condensation of cavities, but cavitary healing with scar formation was not almost seen and these incompletly healed cavities remained so called “target-point” for surgical operation.
2) During the observation 21 cases (77.8%) of 27 cases treated by three drug regimen became negative within 6 months for tubercle bacilli and conversion rate for tubercle bacilli within 9 months was 88.9%.
It is noticeable that conversion rate of the group treated by SM and PAS was, 45.2% within 6 months, 64.6% within 9 months and 29% of this group remained positive during the course.
3) Twenty one cases (91.3%) of 23 cases of the former group showed bronchographically remarkable improvement, (neither expanssive image and strictural blocking nor unstability of the wall of bronchi) and moderate improvement (slight cylinder form enlargement of bronchi, but no strictural blocking or unstability of the wall).
Fourteen cases (66.6%) of these improved cases showed roentgenographically cavitary closure and cavitary healing of scar formation. In the latter group only 9 (32.1%) of 28 cases showed bronchographical improvement and only 2 (22.2%) cavitary closure.
This report, above mentioned, suggests that so-called “Japanese three drug combined therapy” employing SM and INH twice a week and PAS daily is more superior to the SM and PAS combined therapy in clinical effects, conversion of sputum for tubercle bacilli, roentogenographic cavitary closure and bronchographic improvement.

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There have been only few studies on the calorie requirement immediately before and after the operation. In order to ascertain whether the calorie requirement is satisfied or not in the present condition of rationing in the hospital, the authors investigated on the calorie requirement of the patients with tuberculosis who has undergone pulmonary resection and obtained the following results:
1) In spite of the condition near absolute rest during the period of several days after the operation, the calorie requirement of the patients were found to be from 2, 900 to 2, 500 cal., suggesting the necessity of high-protein and high-calorie diet.
2) The calorie requirement after the operation, although varying somewhat according to the period after the operation, showed a value of 10 per cent of what it was before the operation.
3) Although the negative nitrogen balance immediately after the operation was marked, the balance recovered to the level before the operation in the third week and remained this level thereafter.
4) During the first week after the operation, neither calorie nor protein requirement was found to be satisfied.
5) In the present condition of the rationing in our sanatorium, the amount of both calorie and protein is not sufficient.

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