Alternation in arterial blood and pulmonary function at various ventilatory situation were subjected to this experiment.
Rabits were used in this experiment, and placed on one of the following 3 maneuvers, i. e.:
1) Tracheal obstruction, 2) pleural thickening. 3) pneumoperitoneum.
The following instrumental setting were used after tracheostomy. These were;
1) Spirogram for gas exchange
2) Scholander for blood gas anlysis
3) Vanslyke microgas analyzer for same purpose.
In the group with obstructed air way, ventilation effect was maintained in relatively adequate level despite of hypoventilation, although Sao₂ showed decreased value.
In the group with pleural thickening, there was no noticeable change atrest, however, there was decline of ventilation effect and limitation of ability on exertion.
In the group with pneumoperitoneum, markedly disturbed ventilation effect and elevation of Paco₂ were recognized even at rest.

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1. I have been engaged in Psychosomatic Center of the Konodai National Hospital for six months, and observed twenty psychosomatic cases.
2. In Japan, patients have little understanding about psychological interview, thus I have had much difficulties in performance of my work. I feel it is necessary to educate the public to improve the present situation.
3. Many psychotics were found among the introduced cases. Therefore, it is important to educate the general physicians for such problems and at the same time to request psychiatrist's co-operation.
4. Ideal Center should be run by general physicians who have interest psychiatry.

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The Hizen National Sanatorium began to take the intensive Cycling-therapy and got a good result of remedy.
The goal of this remedy is as follows. Psychiatric patients behave as a group, act together with understanding, reliance and support, have so strong will that may train their body and spirit.
We divided 14 members into 2 groups, young and healthy one into first group and relatively old and weak one into second group.
While we inspected their spontaneity, collaboration, and responsibility during the initial, middle and latter stadium, every patient showed good result of this therapy.
All the members of patients showed in increasing of average occupational scores in Kraepelin Test.
By travelling to the unknown places on bicycles, their behavior became to be keen and smart.
When we read a description of patient's impression, we found that they have gotten confidence of discharging to society and they felt more cheerful than living in hospital.
Only one patient refused to have this therapy.
After this therapy, 2 patients have been discharged, 7 patients have become to be patients of Night Hospital.

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It is well known that the calcium in the serum of tumor-bearing animal is normal in the early stage, then gradually decreases from the middle to the last stage.
Examination of the literature revealed that the growth of the tumor cells was controlled by the quantity of calcium, and that the survival time of the tumor-bearing animal was prolonged by feeding or medication of calcium, but shortened by eliminating it.
Observations were made upon relations between survival time and calcium metabolism of tumor-bearing animals by means of administrating solely EDTA-2 Na for decalcifying purposes, then Mitomycin C (M-C) with together.
“Ascites hepatoma cells AH-130” were used on a group of rats, and they were all dead in an average of 14 days after the injection, The serum calcium was decreased in the early stage, and after increasing temporarily, decreased again in the middle stage, and then decreased remarkably at the last stage.
Then “Ehrlich ascites tumor cells” were used on a group of mice. At this time, the average survival time was 17 adys. Injecting subcutaneously 0.2mg/g of EDTA-2 Na to those tumor-bearing mice every day for six days, the average survival time was shortened to 13.6 days, on the other hand, by the injection into the abdominal cavity of 0.2γ/g M-C per day for six days, it was prolonged to 23.4 days. However, when both drugs were used together it was 19.4 days. The serum calcium increased again, after decreasing temporarily, regardless of the injection of EDTA-2 Na or a great quantity of M-C. Also when 0.2mg/g of EDTA-2Na and 0.2γ/g of M-C were used continuously every day, a quantity of calcium was recovered after the decreasing. By this fact, there seems to be not much difference of the effects on the calcium metabolism between the two drugs.
From the above observations, it is understood that those decalcifying drugs shortened the survival time of the test animals, nevertheless it cannot be affirmed that it was caused by the decalcifying effects of the drugs.

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The author discussed the diagnosis and treatment of this disease, and reported the endresults of 289 patients who had been treated by posterior approach.
In the diagnosis of the herniation, the complaints, physical signs and neurological examination were considered to be the most important factors, and should be supplemented by radiographic examination. In the radiographic examination, motion of the lumbar vertebrae, especially of the intervertebral joints should be evaluated to obtain an accurate diagnosis. Besides these examinations, the author discussed on the diagnostic value of the phlebographic and myelographic examination.
In the treatment for the herniation, conservative treatment should be done in the initial stage to decrease the inflammatory processes both at the sciatic nerve roots and in the extradural space, because the pain could be elicited by vascular inflammatory process at the nerve roots and in the extradural space, associated with the herniation pressure upon the nerve root. When the pain does not decrease or reccures repeatedly, traction treatment should be done for three weeks. The surgery should be performed when the traction and other conservative treatment are unsuccessful; and in the indication of the surgical treatment, the age and the occupation of the patients should be considered.
The author prefers posterior approach than the anterior approach in the surgical treatment for the herniation. In the surgery, the smaller invasion and the more extended exposure are desirable to make the post-operative sequelae smaller and to remove the herniation more completely. From these standpoints, LOVE's operation and the ‘Partial hemilaminectomy’ seem to be the most favourable technique. The details of these techniques were also described.
In the follow-up results, excellent and good were 87 per cent of the all patients, and 85 per cent returned to their former occupations, however, 41 per cent of the patients have still complained of instability and pain at the low back.
The surgical treatment alone should not be responsible for these complaints, because these complaints are not seldom in the patients who were treated conservatively; moreover, myelography is thought to be one of the cause of these complaints.

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Conservative versus surgical treatment of herniated intervertebral disk has been a controversial subject for many scholars. We should like to discuss this problem from the standpoint of conservative treatment. The common means of conservative treatment are manipulation, continuous lumbar traction, application of heat on the hip, medication, and the use of brace. As to manipulation there are both pro and con. We fell, however, it should be tried once, at least in the early stage of the herniation, althogh we are not too optimistic about the result.
Conservative treatment should be continued, if radicular symptoms disappear after three weeks of lumbar traction, or, even when mild radicular symptoms persist, if it is the first herniation and the myelogram is negative, or the non-laborer patient decline surgery.
The latest four year result of our treatment is as follows: of the total 119 cases of herniated lumbar disk 63 cases (52.9 per cent) had conservative treatment and 56 cases (47.1 per cent) had surgery. The follow-up study of 52 of 63 conservatively treated cases revealed 19 nearly cured (36.5 per cent), 15 unchanged or slightly improvd (23.8 per cent), and 18 relapsed or operated cases (34.6 per cent).
Hitherto reported incidence of cure under conservative treatment is approximately 30 per cent. This means 30 per cent of the patients with herniated intervertebral disk have good chance of cure by conservative treatment. Surgical intervention on the mild case often leaves post-operative complaint as hazardous as the preoperative lumbar pain. We believe, therefore, that the surgical treatment of herniated disk should be weighed seriously only after long observation under conservative treatment.

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Two hundred and forty-eight patients with sciatica were treated during the period from 1946 to June, 1954 Ofall the patients, 60 cases were treated conservatively with various combinations of medication, corsets, massage, short wave diathermy, bed rest, pelvic traction or manipulation. The remaining 188 cases were operated upon, 151 cases were found to have intervertebral disk herniation at the time of operation.
The postoperative results were analysed from the following view points.
(1) Follow up results after removal of intervertebral disk herniation.
Excellent (No complaints and restored full working ability) ……62R
Good (Complaints relieved, but having occasional discomfort and diminished working ability) ……23%
Fair (Unrelieved) ……13%
Poor (Worse) ……1%
(2) Low back complaints.
Five criteria were assumed to asses the degree of the back complaints. a) Easy fatiguability, b) Disability to walk over 4km, without feeling of weakness or heavy sensation in the lumbar region, c) Disability to stand on the semi-sitting position for over 30 minutes. d) Disability to lift a heavy load, e) Uncomfortable sensation in the lumbar region. The low back complaints are graded as (-), when the patients have none of the criteria. These are graded as (+), when the patients have one or two of the criteria, and are graded as (++), when the patients have more than three of them.
The low back complaints (-), (+) and (++) were noted in 49%, 26% and 25% of the 100 surveyed patients respectively.
(3) Occupation after operation.
Eighty-eight per cent of the patients returned to their former occupations and 7% of them changed their works from heavy to light ones. The rest of 3% (three cases) remained unemployed for the reasons that the first case had difficulty in finding job, the second had no mind to work and the last were suffered from postoperative sequelae (thrombophlebitis femoris).
(4) Sequelae after surgical treatment.
Physical examinations were made on 32 patients received surgical treatment and revealed that 12 cases of them had postoperative sequelae.
Peroneal nerve palsy …… 1 case
Sensory disturbance (hypaesthesia) …… 2 cases
Limited straight leg raising and tenderness on pressure of sciatic nerve and its arborizations …… 4 cases
Tenderness on pressure of the sciatic nerve and its arborization …… 5 cases
It is of myy opinion that the numbers of 32 cases are not large enough for valid statistical deducation regarding the surgical results of 113 patients, but as far as the results obtained from this small group of the patients are concerned, these are satisfactory ones.
(5) Frequency of postoperative low back complaints in relation to the kind of occupation.
Heavy workers such as truck drivers, carriers, farmers or lathe men were more liable to suffer from the postoperative low back complaints than light workers such as teachers, students on office men.
Conclusion;
Careful selection of patients for surgery is essential. Our indications for surgery are as follows:
1) Conservative treatment by hospitalization and absolute bed rest over a period of more than three weeks fail to bring improvement.
2) Recurrences sciatica and low back pain are frequent.
3) Limited straight leg raising is persistent.
4) Sensory or motor disturbance is persistent.
Laborers engaged in heavy labor should be advised not to receive disk surgery because they complain of postoperative low back pain very often after surgery.
Disk excision are done by osteoplastic partial hemilaminectomy (Kondo) on osteoplastic partial laminectomy (Love). Moreover, if there is marked instability in the affected part of spine the spine, fusion may be necessary.

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Thirty consecutive patients who were followed over six months after disk removal were studied, especially to evaluate the relationship between the postoperative disabilities and rehabilitation.
The osteoplastic hemifaceto laminectomy (Rondo) with extradural approach was done in sixteen patiens, the osteoplastic faceto laminectomy in thirteen and an another technic was performed in one.
The results was excellent in twenty, good in nine and unimproved in one. Eight patients with good result left some disabilities.
Roentgenograms were taken followed by Hasegaw'as method and the measurements were done by the compass test of Morgan.
In many patients with some disabilities the narrowing of the intervertebral space and the instability of the vertebrae were seen roentgenographically and the mobility of the verte-brae was more or less restricted.
Patients who were allowed out of bed before six weeks after the operation were likely to show the narrowing of the intervertebral space and the instability, and patients who were not permitted to get up for eight weeks or more and who were not encouraged to exercise were prone to have disabilities and the restriction of the lumbar mobility.
From this study we now employ the following after treatment: The patient is kept in bed rest in plaster back shell, which is changed to back support after four weeks. From a few days after the operation the massage of the lower extremities and leg exercises are encouraged. Four weeks after the operation exercises for spinal and abdominal muscles are begun in supine, prone and lateral position. The patient is allowed out of bed in six weeks and begins vigorous remedial exercises in gymnasium.

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We introduce the new operation technic, “osteoplastic median iaminectomy and wire fixation (Takeda)”.
Indications:
1) Median and bilateral herniation
2) Suspicion of cauda tumor
3) Intradural operation
Technics:
1) without resection of the intervertebral joint including total spinous process, triangular osteotomy is performed on the both sides of the lamina which are removed temporarily.
2) Ligamentum flavum is dissected for the widening of the operation field. After the nucleotomy, the lamina is brought in the same region.
3) The apex of the spinous process and the basis of the superior and inferior spinous process are sutured by the wire for the fixation.
We consider this opetarion technic would be very beneficial for several points, which are widening of the operation field, accurate osteoplastic and good course after the operation.

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The authors reported 3 cases of dysuria caused by pressure of osteochondroma which developed at the synchondrosis pubis.
All the patients were above 60-years-old men, and were clinically diagnosed as prostate hypertrophy.

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