Serial clinical observations were made on 6 cases diagnosed as typhoid or paratyphoid fever and a carrier of paratyphoid B bacilli based upon bacteriologic and serologic studies among 9 cases with clininical typhoid and paratyphoid which have been observed recent 4 years (1960-63) in the Chikushi National Hospital and Fukuoka Center National Hospital.
The results obtained were as follows:
1) The majority of cases excluding a carrier occurred in late winter.
2) Most patients with typhoid or paratyphoid fever were sent to our hospital at the end of 2nd week or the beginning of 3rd week of the disease. It should be emphasized that even today if a case with high fever unknown etiology would be seen, special attentions should be payed to the possibility of typhoid or paratyphoid fever, and bacteriologic and serologic studies should be carried out before the administration of antibiotics.
3) From the early stage of the disease, 2.0 gms or more of chloramphenicol with or without adequate another antibiotics should be given for 7 to 10 days in order to prevent relapsing of the disease. None of fhe cases was treated by antibiotics with steroid hormone.
4) Five cases showed favorable course after administration of a daily dosis of 3.0 gms of chloramphenicol for more than 3 days excluding a case with paratyphoid B and a carrier of the same bacilli.
5) It is still difficult to treat a carrier of typhoid or paratyphoid bacilli using antibiotics without surgery.
A carrier of paratyphoid B bacilli, 64 years old female, who was given 60 gms of chloramphenicol (30 gms orally and 30 gms intramuscularly), 10.8 gms of erythromycin and 135 million units of colistin, orally was discharged from hospital as a permanent carrier on 60th day of hospitalization without surgery.
6) From 7 cases, 2 typhoid strains, paratyphoid B strains, and 1 paratyphoid A strain were recovered. Sensitivity tests for antibiotics to these 5 strains were done. All strains were most sensitive for chloramphenicol and kanamycin, 4 of 5 strains showed most sensitiveness for tetracycline.
Therefore, combined administration of antibiotics such combinations as chloramphenicol and kanamycin or chloramphenicol and tetracycline to typhoid or paratyphoid cases should be tested.

View full abstract

Between October, 1953 and July, 1962, 145 patients with cancer of the esophagus and the cardia were seen at our clinic, Surgical exploration was carried out in 92 cases. We studied on the causes of death following resection of esophageal cancer in 92 operated cases. The results were as following.
1) Resections of the esophagus were carried out in 82.8% of the total cases and resections with the intrathoracic esophagogastric or esophagojejunal junction were performed in 71 cases.
2) There were 22 deaths as a direct result of the operation, the rate of the operative mortality being 24.7%. The mortality of resection with the intrathoracic anastomosis was 26%, while that with the intraabdominal anastomosis was only 8.3%.
3) The operative mortality was higher in cases with cancer in the upper half than the lower half of the esophagus. The narrower the stenosis of the esophagus was and the longer of tumor was, the higher the mortality was.
4) Postoperative complications appeared in 16.8%, with the mortality of 51.2%, where the leak of junction occurred in 11.2%, the spontaneous pneumothorax in 9%, the excessive blood loss in 5.6% and the acute cardiac failure in 5.6%.
5) Under the causes of death the most frequent were the leak of junction and the spontaneous pneumothorax, the next being the lung complication and the excessive blood loss.
6) The causes of the spontaneous pneumothorax were unable to explained by autopsy, but we thought that it had the causal relation with the leak of junction.

View full abstract

The authors inquired and considered 196 cases of cephalic trauma patients since 1959. Most of these cases were caused by the traffic accidents, and of the mortality cases, and the causes were quite similar except only one, Considering that 13.9% of the wounded were intoxicated when they were injured, the influence of liquor are serious.
As to the age of the wounded, in accordance with the accepted reports, the number the twenties was largest and that of the infants and little children came next. As to the time of the occurence of the accidents, most of the accidents occured in the afternoon. The degree of unconsciousness and the length of its elapsed time are considered to have serious influence on the prognosis, but the case in which the wounded had been unconscious for six days, was happily cured and the patient progressed favourably after leaving the hospital.
The existence of the shock-symptoms and the recovery from such symptoms have been said to have serious influence on the prognosis too, and this was proved to be true through the following facts:
(1) Eight of the 13 wounded whose temperature had been lower than 35°C died.
(2) Seven of the 14 wounded whose pulse had beaten less than 50 died.
(3) Eight of the 44 wounded whose blood pressure had remarkably fallen died. So in the existence of the shock symptoms the treatment, of the wounded should not be delayed aid the long transportation of the patient in such a case must be prohibitted.
Too high temperature has a great influence on the prognosis too and considering that within four days after the attack of the high fever all of the wounded died, the positive application of the low temperature treatment shoud be taken in future. Moreover considering the necessity of the judgement of the prognosis by using the puncture in lumbar vertebra we have lately used an early puncture in lumbar vertebra and no trouble was noticed.
The increasing of leucocyte should be refered too, and in the case of the encephalic contusions, 5 of the 23 wounded whose leucocyte number had been larger than 10, 000, died. As the local symptoms of the brain, the abnormality of the tenotomy reflexion often appeared but this was not always in accordance with the symptoms and the fact that the death of 12 of the 27 cases in which the abnormality of the pupil appeared, is considered to be one of the most important factors for the judgement of the prognosis.
Headache, vomiting and nausea often appeared in the slight illness, so these cannot be refered so much for the judgement of the prognosis. But these were complained when the patients were about to leave the hospital and so close attention should be paid in treatment.
As to the plan of the treatment, very few operations were performed, but considering that in the 8 cases of autopsy, there was only one case in which the operation had been applicable, therefore careful consideration shoud be given for deciding the operation Mortality rate through our treatment was 3.5% and this is not so high as the percentage compared with other reports, so it can be said that the application of the operation must be decided very cautiously.

View full abstract

Non-bacterial cystitis, included cystitis hacmorrhagica and cystitis exsudativa, were studied on allergy clinically, therapeutically, haematologically and biochemically.
1) On clinical the obvious antigen was not found, but the complication and the anamnesis of allergic diseases were found on 39.4 per cent, the Dermographismus on 37.5 per cent.
The clinical symptom of these cystitis excepted cystitis haemorrhagica and cystitis exsudativum were slightly.
2) On therapeutical the anti-allergic compound (Strong neominophagen C) was effective on 80per cent.
3) On haematological the clear eosinophyly was a little.
4) The kalium and K/Ca in the serum were more than normal and the γ-globurin little.
As a sumary, the allergy is the etiology on these cystitis or a part of the etiology.

View full abstract

This was compared with 6 other various Fe-medicaments and reducing Fe, on the action of tannic acid in the Japanese-tea as usually.
Using the Electric-Spectrophotometer (reported by T. Morikawa's method), we have made an experiments of the tannic acid and Fe-medicaments in the artificial gastric juice referning to the literature written on this subject. From the above exmeriments the following conclusions were obtained.
It is no particular lost of Fe by tannic acid has been noticed. On the basis of the various points listed above, it is considered that the take no teas at the time when Fe-medicaments.

View full abstract

A well demarcated, small, solitary, round and homogenous shadow was roentgenologically observed in the left upper field of the lung of a 25 years old mare who had been scarecely complaining.
This case was diagnosed as suspicion of tuberculoma before operation. The histological examination cf the removed tumor showed a chondroma.
A statistical study of several cases operated previously in Japan was referred and roentogenological and histological characteristics of this disease was discussed.

View full abstract

We have made a joint use of Anadrol and Kolantyl to 15 patients of gastric ulcer and obtained following results.
1) 13 patients (86.7%) obtained satisfying relief and 9 patients (60%) showed radiological evidence of healing.
2) In series of the latter, the combined therapy was more effective and reduced therapeutic duration than the therapy of lone kolantyl alone.

View full abstract

I tried to investigate “Recreation Test” of 135 male and 52 female mental patients recieving occupational therapy. As a result, it was found that a number of male patients incline to like single out-door sports while female patients are interested in indoor amusements.
Of course, there are several differences by age among them. As a whole, if mental patients selected their special amusement, they would like to participate them mostly. However there are some patients who dislike “PARTICIPATING” although they select.
Mental patients for a short period of hospitalization contract no hospitalism, appear vigorous, and are having a hope of to be discharged, and their “Participation Score” show higher, I can find mental patients for a long period of hospitalization are falling into hospitalism, have no activity. I consider they should be given with an aspiration, and be let with case-work under social and familiar connections.
I discover patients on locked ward are having higher “Participation Scores” because they enjoy their recreation for limited times. As patients on open ward have so much hours in hospital life, they can not afford to make use of time wisely.
Occationally it is neccessary that we have to lead them under limited times as much as possible.

View full abstract