The ortho pregnancy test was done on the 100 cases of out- and in-patient of pregnant women, in a part of which the possibility of this test in the quantitative determination of urine chorionic gonadotrophin was studied and comparison with Aschheim-Zondeck test was performed. The macroscopic accuracy of this test was also compared with the calorimetric method.
These results suggest that biochemical determination for pregnancy can simply be made with this test without using animals or any equipments other than a centrifuge and a thermostat.
The benefits are (1) it only takes less than three hours to complete all reactions, (2) can read the result macroscopically with no significant difference from colorimetrically, and (3) be able to practice with ease the procedure of this test. For the quantitative determination of urine chorionic gonadotrophin should be done with the serum more higher and more clear antibody titer.
And another problem of expensiveness of this test will be solved near future.

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Mass medical investigation was carried out for the purpose of clarifing the epidemic state of Paragonimiasis in the whole coastal region from the north part of Fukushima to the south part of Miyagi prefectures. The results were as follows:
1) In 1, 041 persons who received the investigation at the basin of the River Mano, 68 (6.5%) showed positive intracutaneous reaction with V. B. S. antigen, and in 1, 469 persona at the basin of the River Uta 78 (5, 3%) showed positive reaction. With contrast to these percentages of positive reaction in Fukushima prefecture, lower percentage was proved to be positive in Miyagi prefecture.
2) At the basin of the Rivers Mano and Uta, the majority of the residents have been used to eat fresh water crabs, but such a custom is not recognized in Miyagi prefecture. Difference of the custom is considered to influence the epidemic state of Paragonimiasis.
3) Paragonimus eggs in sputum and stool were proved in 12 out of 140 persons who showed positive on V. B. S. reaction.
4) For 100 persons who showed positive on V. B. S. reaction, the chest roentogenography was performed. Six out of them showed abnormal shadows obviously due to Paragonimiasis, and 68 persons had no evidence of the pathological findings.
5) Recently the fresh water crabs in this region are decreasing in number, accordingly the residents have fortunately fewer opportunities to be infected with Paragonimus.

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In the summer of 1960 a girl with cerebral paragonimiasis was admitted to the psychiatric service of Chikushi National Hospital from Kami-agata Country (Tsushima Island), Nagasaki Prefecture and she died shortly after hospitalization. Her parents also were suffering from paragonimiasis, and had no knowledge about the disease, Since this incident, we have carried out epidemiologic studies for four years, and some campaign of education regarding paragonimiasis in Tsushima, Namely, parasitologic studies on the crabs, or the skin test, and explanations concerning life cycle of paragonimus using many slides for the inhabitants at various places have been done. In addition to these, since 1961 in every year 2, 000 copies of the pamphlet for education have been distributed to the people in Tsushima. On the other hand through the newspapers, radio and television the importance of prophylactic measure has been emphasized to the inhabitants, According to our studies, parasitic rates of metacelcaria in the Nita River (especially 24.3% in Kurusu), 42.5% in the Mine River, 59.8% in the Kusu River, 58.1% in the Are River, and 80.0% in the Azamo River, which appeared to be high positive rates.
High positive results of the skin test obtained from school boys and girls using the VBS antigen were 22.7% in Sago area, 37.6% in Hamagusu, 21.9% in Are, and 23.8% in Naiin. High positive skin test corresponds with high parasitic rate of metacelcaria in the crabs in these districts, In the skin test for 1816 individuals among the inhabitants in Sago, Nita, Mine and Are areas, where appeared to show high infectious rate, the positive rate was 22.6%. In 1962, the questionnaire was sent to every home in order to know the inhabitants' response to our campaign of education and some following interesting data were obtained.
The spread rate of knowledge about the disease among the inhabitants are showing remarkable increase, namely 33%, 34% in 1960, 1961, and 1962, respectively.
As to the processes obtained the knowledge, 35 per cent of the people owed to the activities of our group, 34% from the talk of folks with this matter, and 2096 from information by the newspapers, radio and television.
In Tsushima, the most families (93 per cent) have tasted the crabs and in 1960 48.2% of the inhabitants ate the crabs. Year by year, however, the eating ratio of crabs was decreasing, i. e., it was 21.9% in 1961, and in 1962 it dropped to only 2.9%. As to the cooking ways of crabs, 66% of people took Miso soup containing grinded crabs, but no one showed such habit as eating the raw crabs.
Since 1960 111 carriers of paragonimus eggs have been found, among them 74 instances by us, 35 cases by the Institute of Endemic Diseases, Nagasaki University, and 9 by doctors in Tsushima. In 1963, under cooperation with the National Tsushima Hospital, group treatment for paragonimiasis cases with Bitin was made and 50 volunteer cases have completed the treatment.

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Prior to describing the paragonimiasis diagnosis and treatment, the epidemiology of the paragonimiasis patients in Miyazaki prefecture has been briefly referred to. That is, the number of patients, in 1955, rapidly attained the summit. Since then the number of patients is gradually decreasing. Upon comparing the intracutaneous reaction between V. B. S. and P. P. T., the latter is more peculiar and sensitive. As to the X-Ray patterns, the majority of which is cavity type with infiltrative and tubercular types following. Furthermore, the extent of the shadow and the length of the inside diameter of the cavity is not so large as that of tuberculosis; thus, the extent is also the valuable point of diagnosis. The phase of the treatment concerning this disease has changed entirely, since the advent of Bitin, and in the case of Bitin, the absorption and vanishment of the shadow is extremely conspicious and rapid, as compared with Emetin. Of the reaction of Bitin, urticaria is estimated as 68%, appearing, mainly on exposed parts. However, the reaction can be prevented by combining ant-histamin and proper medication. There has been no instance of relapse.

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1) Results of the chest X-ray survey for pulmonary tuberculosis combined with the parasitological examination for paragonimiasis among the school children in Ehime prefecture.
Mass examination against pulmonary tuberculosis combined with screening test for paragonimiasis were carried out 1957, for 4, 371 school children in endemic area of paragonimiasis. Results were as follows, a) 5.3% was positive for intra dermal test with V. B. S. antigen, and 2.5% was doubutful. b) 28.6% out of the positive cases and 1.8% out of doubtful cases for intradermal test were positive for egg test. c) Besides 101 out of 4, 371 showed radiological change in chest X-ray pictures. Out of 101, 55 (54.5%) showed calcified shadows, 34 (33.7%) were proved as paragonimiasis, only 2 were diagnosed as pulmonary tuberculosis. Next, in 1960, a big scale T. B. mass survey by chest X-ray examination were carried out for 24, 686 school children of 45 middle and primary school which were lccated along main rivers in Ehime prefecture. All children who showed radiological changes in direct chest X-ray picture were further examined to detect mainly pulmonary paragonimiasis. Results were as follows. a) 175 (0.71%) out of 24, 686 school children showed radiological changes in chest pictures. Out of 173, 65 (37.6%) were positive and doubtful for intradermal test of paragonimiasis, out of 63, 40 (63.5%) were positive for egg test. Namely, out of 173, 40 (23.1%) were proved as paragonimiasis.
From the above results, it is necessary that T. B. mass survey must be carried out together with screening test for paragonimiasis, especially in the endemic area.
2) Radiological findings of pulmonary paragonimiasis.
Its radiological findings is similar to those of pulmonary tuberculosis. But its changes can be characterized. Of course, to determine the diagnosis of paragonimiasis, it is necessary to clear for eggs in sputa or stools. But when we find doubtful radiological changes in chest X-ray, should further examine with screening test of paragonimiasis, and we can determine the diagnosis of paragonimiasis.
3) On the treatment of pulmonary paragonimiasis with Bithionol.
In 1961, 23 cases of pulmonary paragonimiasis received treatment with Bitin (Bithionol) in Ehime National Sanatorium. Namely, out of 23, 12 were given Bitin in the daily dose of 50mg/kg every other day, 11 were given 40mg kg. And all cases were received 15 daily doses. Results were as follows, a) Effect: All cases were cleared for eggs in the sputa or stools with 1-12 daily doses of Bitin. The followup studies were carried out for 6 months after treatment. All cases continuously were cleared. b) Side-effects: They came out frequently and included the following, such as headache, diarrhea, vomiting, abdominal pain, drug eruption. But almost all of them were mild and transient. 3) Radiological findings: Radiological improvement began soon after treatment, and was remarkable. Namely, at end of treatment, out of 20 infiltrative shadows, 2 showed marked improvement, 10 showed moderate improvement. More, at 3 months after treatment, out of 18, 15 (83.3%) showed marked improvement, and 3 (16.7%) showed moderate improvement.
From the above results, chemotherapy with Bitin has been found to be a very remarkable regimen in the treatment of pulmonary paragonimiasis.

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Since August 1960, the authors carried out the common studies with Dr. Muneo Yokogawa and co-workers (Dept. of Parasitology, School of Medicine Chiba Univ.), on the treatment of human paragonimiasis applied Bitin (Tanabe Co.) and proved that Bitin is quite effective for this disease.
1) Administration and dosage: Usually 30-40mg/kg daily divided 2 or 3 doses after meals every other day for 10 days.
2) The antibody titers in complement fixation test were shown the tendency of decrease gradually and became negative during the period from 1 to 12 months after the completion of the treatment.
3) Most of the abnormal schadows found in chest X-ray films before the treatment showed the tendencies of disappearances or reductions immediately after the completion of the treatment and disappeared within 12 months.
4) No relapses were found in any cases from the results of follow-up examinations maximum for about 3 years after the completion of the treatment.
5) The side-effects such as diarrhea, abdominal pain, nausea, vomitting or urticardial erruption were found sometimes during the period of the administrations of Bitin, but they were all trancient and mild.

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Lung flake often moves out of the lung, and emigrates into other organ or tissue of human body.
The author reported many cases of extrapulmonal paragonimiasis already. In this symposium, the author demonstrated some interesting cases, such as pleural, cerebral, or subcutaneous paragonimiasis, and explained the important points of consultation.

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1) Two cases of cerebral paragonimiasis were reported,
2) Both of them were satisfactory treated by neurosurgical operation,
3) The first case shows remarkable calcifications on the cranioradiography.
4) The second case has a large cyst in the temporal lobe and the patient became comatous after short course.

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Result of the investigation on distribution of Gnathostoma spinigerum Owen, 1836 on the basion of Tsuboi- and Shirakawa-River flowing through Kumamoto-City:
1) Basions of a branch of Tsuboi-River and Iseri-River were found to be distributing places of Gnathastoma spinigerum Owen, 1836 from the investigation of Ophicephalus argus.
2) As to second intermediate host of Gnathostoma spinigerurn Owen, 1836 distributed on the low Tsuboi- and Shirakawa-River, Ophicephalus argus and Parasilurus asotus were reported.
3) Parasite parts were found in the muscle of Ophicephalus argus and Parasilurus asotus. The latter was found newly as the host of Gnathostoma spinigerum Owen, 1836.
4) As ta Cyprinus auratus, Anguilla japonica, Misgurnus anguilli caudatus, Odontobutis obscura, Rana nigromaculata nigromaculata, R. rugosa, Eriocheir japonicas, Sesarma haematocheir, S. intermedia, S. dehaani, Cambarus clarkii on the basions of Tsuboi and Shirakawa-River and C. auratus, Parasilurus asotus, R. nigromaculata nigromaculata, R. rugosa on the basion of Iseri-River were not found.

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