The most important matter in the management of acute craniocerebral injury is to determine whether or not an intracranial hematoma and/or cerebral edema are present. It is well known that signs of an intracranial bleeding are (1) deteriorating consciousness, (2) Iateralizing neurological signs including focal signs, transtentorial - & tonsillar pressure cone, and (3) changes in vital signs. If any of these signs appears, we immediately perform carotid angiography (bilateral) for suspicion of cerebral lesion and vertebral angiography for posterior fossa lesion. If angiograms show hematoma or signs of herniation, immediate surgical treatment will be done.
Among these 3 cardinal signs, there are some intracranial hematomas failing to develop lateralizing neurological signs, or taking quite a few time for these signs to appear.
On the other hand, some cases do not always reveal changes in vital signs, which has been pointed out by Dr. Schneider.
Therefor we should like to emphasize “deteriorating consciousness”. The level of consciousness is devided into 8 degrees. As a rule, if the patient's consciousness deteriorates even one degree, we make a practice of considering him (her) a candidate for surgical intervention.

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The authors described briefly about the indication of treatment for acute stage of serious head injury.
The diagnosis of intra-cranial hematoma should be chiefly determined by clinico-neuro-logical signs. In these cases the disturbance of consciousness and anisocoria are two most important signs. The pyramidal sign is nextly important, but this sign appears especially in subacute or secondary stage of the brain injury.
Cerebral angiography and other methods are performed generally. In acute stage angiography is performed mainly for brain confusion.
In case of suspected intracranial hemorrhage the cerebral angiography is performed for its assurance. Therefore the preparation of those examination alway should be done readily.

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Seventy six cases of urticaria had been treated in our Allergy Centre during the period from July 15, 1954 to July 14, 1965. The results of clinical studies especially of the intracutaneous test are as follows;
1) As to the sexual distinction, on the whole, the number of the male was almost the same as that of the female (1: 1.05), but in the youth-prime generation the female was predominant in number, and the third decade was most frequent then the twenty decade.
2) Observing on the type of urticaria, 52.6% of the total cases belonged to the chronic type, and 25.0% were the acute.
3) 68.4 % of the 76 cases had the hereditary factor.
4) 63.2 % of the patients with acute type of urticaria and 32.5 % of those with chronic type of urticaria had food allergy, most frequently caused by fish (as mackerel, tunny, bonito and horse-mackerel) and smell-fish, and frequently by egg, cereal or vegetable, meat and milk.
5) The intracutaneous test by food allergen extracts was applied on each subject.
The frequency order of positive reaction was as follows: firstly as to fish and shell-fish group, lobster (23 %, the highest of all), tunny, bonito, crab, salmon, sardine, cuttlefish, and so on; secondly as to egg, meat and milk group, processed food (such as sausage or ham) and so on; and lastly as to cereal or vegetable group, positive reaction was caused
by cortinellus shiitake, bamboo-shoot, egg-plant, tomato, spinach, taro, coltsfoot and peanut. But the positive reaction to intracutaneous test of these substances, especially in chronic urticaria, was generally less notable than in bronchial asthma, and either false positive or false negative reaction was often seen.

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Since 1933 investigating upon bacterial infections in urolithiasis Staphylococcus, Escherchin Coli and Froteus were isolated from that urine numerously. On half the number of which were treated surgically, pyelonephritis or cystitis remained after operation(lithotomy).
We have to turn out attention to these diseases which might be develope chronic pyelonephritis and renal hypertension.

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During ten years from 1955 to 1964, there were 524 cases of urolithiasis among 7445 cases of total out-patients in our Derrnato-Urological Clinic.
The ratio of these patients to the total patients was 7.0%, and the patients with calculus in upper urinary tracts were on the increase, but these with calculus in the lower tracts were not so.
The following tables show several and statistical observations regarding the locations, sex, age, occupations, recurrence, chief complaints, and therapy on urolithiasis.
Regional distribution; kidney stone was seen in 120 cases (22.4%), ureteral stone in 304 cases (56.8%), bladder stone in 56 cases (11.7%), urethral stone in 18 cases (3.4%) and prostatic stone in 26 cases (4.8%).
Age, sex and side. The highest incidence was seen in the twenty decade which occupied 26.1%. Urolithiasis occured more frequently in male than in female, predilection was observed in the left side.
Symptom; The chief complaints were pain in the flank and abdomen (75%), and lumbago (14.6%).
Treatment. Operation was mainly carried out for the stone in the upper urinary tract.

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A Method of examination and control of the essential hypertension which were used at the Hypertensive Clinic Center of the First National Hospital of Tokyo were introduced, for the purpose of deciding of a definite formula of them. Various examinations regarding blood pressure, eye ground, cardiac function, neurocerebral status, and renal function were
made on hypertensive patients. From results of examinations the severity index of the U.S. Veterans Administration (1960 Protocol) was applied to the hypertensive patients and they were divided into three groups, namely, mild, moderate and severe cases. Mild and moderate cases were controled as outpatients with somewhat limitation of their life and diet, with administration of sedatives and antihypertensive drugs among which
Chrolothiazide or Reserpin were first drug of choice. Severe cases and young hypertensive patients were admitted to the hospital as a rule for further examinations and treatments of the disease.
A prognostic study of the hypertension were made on 748 cases of hypertension, applying the severity index of the Japanese Ministry of Welfare which was established in 1964. Increasing the severity index, the much more mortality rate was revealed.
Practical usefulness of these two severity indexes was emphasized, for both primary examination and detailed examination of the hypertension.

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In treatment of hypertension, it is necessary to discriminate between Primary (essential) hypertension and Secondary (symptomatic) hypertension. In the case of secondary hypertension, the remedial measures to be taken on each original disease must be established.
In order to observe the course of essential hypertension, to consider the prognosis and to determine a drug therapy for hypertensioe disease, grading on the severity hypertension should be closely evaluated. Each severity index was drawn from the findings of blood pressure, optic fundi, cardiac, renal and cerebral status to determine a total index, upon
which a guide to therapy was based on.
Grades I and II refer to mild or molerate degree, to which most oat-patients of hypertension belong. These are gro cps which can be treated bj gaidanre on care at home including proper diet and the hypotensive drug to be taken.
Grades III and IV are severe groups of malignant phase requiring hospitalization. It is believed that these cases can be properly treated through repeated examination on grading of severity.

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The author et al. have made studies on 259 subjects of hypertension who ranged in age from 15 to 35 years. Consequently, the cases that their factors could be concluded, were defined as the secondary hypertension and the one that did not, was as the primary hypertension. The former showed 19.3 % and the latter was 80.7 %.
1) In secondary hypertension, 70% of which was renal impediment, that were nephritis, cystic kidney, pyelonephritis, hydronephrosis, nephrolithiasis, movable kidney and etc. The rest of them were 5 cases of the primary aldosteronismus, 1 case of hypertrophia of medulla of supra renal gland, 3 cases of disorder of blood vessel and the other five cases.
2) Results of the investigations upon the primary hypertension.
a. Significance was found in 47.6 % which had hereditary factor.
b. 11.3% showed fatness in their physiques and can not be ignored as one of the cause of hypertension.
c. Renal biopsy was carried out on the cases in which microscopic urine albumin was marked, though being normal in renal function without history of nephritis. There were considerable changes in blood vessels, stroma of renal tubles and Bowman's capsule. It would be necessary to protect kidney because of some changes were noted in renal biopsy, regardless of an existence of albuminuria.
d. 41.3% showed some changes in E.K.G., especially of liability upon left heart, for which protection of kidney required in some cases.
e. Only 3.7% showed over 250 mg% of serum cholesterol level.
f. 2 cases out of 50 cases showed high level of quantitative urine vanil mandelic acid, but became normal after repeated test. In this case, tumor of medulla of supra renal gland could be ruled out and psychogenic factor was strongly suggested.
g. The eye ground changes belonged up to the KW II group, was marked in a few cases.
h. In the angiotensin intracutaneous test, many showed hypersensitiveness which was differed from the other type of hypertension and the control, but they were not related with the medum of blood pressure and successive time of induration.
i. In plethysmoangiogram, a group of juvenile hypertension presented a different phase from that of the middle and old ages.
j. A half of the total cases showed descent of blood pressure without having antihypertensive drugs, and this tendency was observed more apparently in the young than in the did ages.
k. In order to investigate the psychogenic factor psychological tests, using Cornel Medical Index (C.M.I.), Yatabe-Guilford Personality Inventory (Y.G.) and Seikenshiki Personality Inventory (I.N.V.), were carried out. As the results, C.M.I. disclosed neurotic tendency and I.N.V. showed nervousness but no peculiar tendency was observed in Y.G. Thus, psychogenic factors can not be denied as one of the factors of the primary hypertension.
In the secondary hypertension, there are some cases which could be treated surgically, but as to the primary hypertension, of which factors could not be found, we realize the necessities to make efforts in order to pursuate their factors, and at the same time to discover them at early period for their treatment.

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Fatty acid compositions of cholesterol, phospholipids, triglycerlde and nonesterized fatty acid were analysed on 40 hypertensive patients without arteriosclerotic complications, 20 hypertensive patients with hemiplegia and 40 healthy subjects.
The results were as follows:
1) As compared with healthy group, linoleic and arachidonic acid were decreased in hypertensive group without arteriosclerotic complications and more markedly in the group with hemiplegia.
2) Oleic and palmitic acid were increased in hypertensive group without arteriosclerotic complications in comparison with healthy group and more markedly in the group with hemiplegia.
3) On stearic and palmitoleic acid, no significant differences were observed between hypertensive groups and healthy group.
4) No correlation between blood pressure and linoleic acid of cholesterol could be observed.
5) On hypertensive patients with and without arteriosclerotic complications, the decrease of linoleic acid of cholesterol in the group of Keith Wegener l were more significant than in the group of K.W. O. and in K.W. H more significant than in K.W. I.
6) An inverse correlation between plasma pbospholipids levels and linoleic acid of phospholipids was generally observed, but no correlation was detected between plasma total cholesterol levels and linoleic acid of cholesterol.
From these results, it is presumed that the above changes of fatty acid compositions in hypertensive patients without arteriosclerotic complications might not be specific to hypertension itself, but rather mean an existence of developing arteriosclerosis.

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The apexcardiograms of 56 systemic hypertensive cases and 48 normal subjects were investigated and analyzed in detail.
The following results were obtained:
1) The exaggerated “a” wave was meant to be the severe systemic diastolic hypertension.
2) The ratio of ejection upstroke to total amplitude (EU/TA) increased gradually to 119 mmHg. (diastolic pressure) but over 120 mmHg, it tended to decreases.
3) When the mid-systolic bulge appered, it was considered generally as severe cases.
Those signs were in dainger of heart failure.
4) Rapid filling time was always constant in any heart rate.
5) Among the hypertensive cases and the normal persons, there were no recognizable differences in connection with time lag of isometric contraction time (I.C.), ejection time (E.T.) and isometric relaxation time (I.R.).

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Five cases with hypertension due to unilateral renal diseases which were submitted to nephrectomy are presented in this report.
Case 1. 24 years old male, arteriosclerotic stenosis of the right main renal artery.
Case 2. 20 years old female, stenosis of the right renal artery due to fibromuscular hypertrophy.
Case 3. 31 years old male, hypoplasia of the left kidney.
Case 4. 28 years old male, renal impairment due to ₆₀Co irradiation to the left kidney region, where a metastatic tumor of seminoma had been palpated.
Case 5. 37 years old female, stenosis of the right renal artery due to arteritis as a manifestation of the “aortitis syndrome”.
In no cases of these 5, vascular murmur over the abdomen was heard.
A Keith-Wagener 4 ocular fundus was transiently observed in Case 4, in which the development of the disease process was very rapid.
In all of the 5 cases, findings of routine intravenous urograms such as delayed excretion and smaller vertical diameter (difference greater than 2 cm) of the impaired kidney played an important role as the initial diagnostic clue.
Radioisotope renography, renoscintigraphy, aortography and divided renal function tests were valuable as ancillary diagnostic methods.
Among others, aortography seems to have greater importance in view of the greater incidence of the so called “aortitis syndrome”, particularly involving the abdominal aorta, in this country. Seldinger's percutaneous catheterization method for aortography seemed to permit better visualization of the arterial tree compared to the translumbar needle puncture method.
Some correlation seems to be present between the histological findings of the removed kidney and the post-operative blood pressure levels.Therefore, bilateral renal biopsy is recommended to be carried out preoperatively for prediction of operative effectiveness or ineffectiveness for lowering the elevated blood pressure.
A significant lowering of blood pressure after nephrectomy was observed in Case 2 only. In Case 1 and 5, increased responsiveness to hypotensive drugs was observed. In Case 4, lowering of blood pressure was observed prior to the operation.

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Conditions of patients with essential hypertension who had their onset in spring were studied in order to grasp their state as distorted nonspecific bioreaction, or dynamics of human vitality. For this purpose, their urine quotients were regarded as indexes assumed. Further, the trend of lipidic metabolism were examined at the same time. The result thus obtained is as follows:
1) In all the cases studied, o/K₄ highly exceeded the normal value, their average value being 93.0 ±5.81. Thus, among patients with hypertension who had their onset in spring, remarkable decline in vitality was noticed.
2) Of the average values measured in various respects, those of total cholesterol, phospholipid and lipo-albumin rate far exceeded their normal values. Especially noticeable was the rise of lipo-albumin rate, its average value being 6.72 ± 0.521, and the number of cases in which it exceeded the normal value being 23 (92%).
3) When all the cases were divided into two groups according to o/K₄, one group having high values, and the other low values, it was found that, in the former group, all the values of total cholesterol, phospholipid and lipo-albumin rate were abnormally high, and, above all, lipo-albumin rate was as high as 7.85 ± 0.865.
4) In short, it is presumed that a distortion of the inside condition in a living body is caused by the stress continuing for some period when one withstand the cold weather, and that this distortion, viewed from the standpoint of lipo-albumin, takes shape as an abnormal lipid metabolism and act as a factor bringing about the lowering of vitality.

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Studies were made on total 85 speciemens, 63 from lung resection and 22 from autopsy, which had seen obtained during past 7 years from 1958 to 1965.
Results:
1) The forms of the giant cells are classified into 8 groups; that is, riped type, granule type, inclusion type, vacuolar type, atrophic type, dissociated type, necrotic type and foreign-body type.
The variety of these changes of giant cells seems to rely upon the length of the treatment.
2) The changes of arrangement of nuclei in giant cells were observed in the lungs treated with antituberculous medicaments, the nuclei tended to arrange indefinitely in the non-serious type tuberculosis, while in the serious type the nuclei in general were crowded circularly to the cell periphery as well as in the cases treated less than 1 month.
These tendency were more marked in vacuolar type and inclusion type of giant cells, and in reference to atrophic or dissociated types it was extremely difficult to distinguish the arrangement of nuclei.
3) The inclusion type of giant cells were found in 11 cases. The inclusions are classified into 4 groups ; that is asteroid body, retiformed body, needle-shaped body and mall-grained body.
Histo-chemical character of these inclusions were not necessarily the same; namely, it is reasonable to presume that: asteroid bodies are consisted mainly of some protein similar to elastin, the majority of retiformed bodies are similar to asteroid bodies in chemical
features, needle-shaped bodies are formed from argyrophil fiber through vacuolen in cytoplasm of giant cells, and small-grained bodies are consisted of calcaroid substance or degenerative concentrate of nuclei.
The inclusion types tend to appear in the margins of incapsulated Gaseous lesions, in small nodules of tuberculous lungs which had treated during 1 year or thereabouts. In these cases the clinical response based on antituberculous medicaments was remarkable or satisfactory except 1 autopsy case.
4) The appearance of the giant cells are a purposeful defence reaction in man. There is a close relation between the changes of forms of the cells as well as the changes of arrangement of nuclei and the formations of argyrophil fibers around or in the cells. It was assumed that these changes in giant cells are based on influence of the antituberculous
medicaments and the immunological status of the human subject.

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An attempt of electric stimulus therapy for pulmonary tuberculosis has been made since October, 1959. This experiment was started for the purpose of electro-chemical or colloid chemical stand point rather than physiological viewpoint.
The electric charging with very low voltage was applied to a cavity of lung of the patient through two electrodes for a long period. After the application of the low voltage, electric current has begun to flow through the body between the two electrodes; however the essential point of this method lies in long period electric charging which results the ionization and migration of the pus etc, by the electrophoresis.
Furthermore, it is considered that this experiment will be utilized for the research work of molecular biology.
The experiment was tried on 200 or more patients and obtained following results.
The changes of the sputa and the cavities of the patients were noticed about two weeks after the long period electric charging was applied. The quantity and color of the sputa changed noticeably. The changes occurred on 40% to 50% of haemosputa and haemoptysis, and about 50% of the cavities changed their sizes and shapes.
The theory of the electric charging for the human body has not been established yet, however, from the basic experiments, the clinical results and the patholgical researches, it is considered that these changes are due to the electrophoresis hydration or dehydration etc, of the pus.
In most cases, the stupe method was employed by placing both electrodes on the skin of the patient, setting carefully so that the cavity will be located between the two electrodes. Then applied low voltage electric current passed through the body. The current was observed by a milliammeter and checked as it was flowing through the body.
The phenomena described above are not due to tho stimulus of iontophoresis which requires very high voltage electricity, but due to the electrophoresis under the long period electric charging at low voltage by the experiment.
The phenomena also will be explained by the theory of electrolysis. From the experiment it was noted that the metal of the positive electrode lost its weight and almost same amount of the metal was deposited on the negative electrode. This is the indication that the metal on the positive electrode was melted, electrically charged, migrated through the body and deposited on the negative electrode similar to the electroplating process. It is known fact that even under the very low voltage H+ and OH- ions
can be formed and migrated easily in the fluid of human body.
The physiochemical aspects between the human body and electron beam will also applicable for the long period electric charging in a wide sence.
The changes of the pus of cavity due to the electric stimulus snggests us that it is not very simple phenomena. In some case the pus becomes inspissate and in the other, it melts conversely. These phenomena are the indication of dehydration or hydration (peptisation) of the pus by the colloid chemical action.
In the stupe method, the neurotic reaction of the skin was not observed and the effect of the stimulus was occurred at the lung locally. So that the stupe method will be applied for the diagnosis to find out which side of lung is active, right or left or both.
In general, the electric potential of a cell membrane is considered so high as 10⁵ volts per cm. On the contrary, it is quite interesting to know that above mentioned phenomena can be observed with very low voltage electricity such as 2-3 volts or less.

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The color scintigram has been used in diseases of thyroid gland by means of radioactive iodine. In this study, Toshiba's color scintiscanner apparatus (RDA-102 type) was. used and the results obtained were as follows.
Color scintigram was five area scanning by color reiflector, therefore, easy interpretation and certain diagnosis could be analyzed into elements compared with existing monoscinti-gram, and it was concluded that color scintigram was more satisfactory than the latter for a detailed studies of thyroid gland.

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A case of intralobar sequestration of 31-year-old woman was admitted to the sanatorium.
Chest roentogenogram revealed a tumor-like shadow in the right lower lobe. Bronchogram revealed filling posterior and lateral basal bronchi were defected.
At operation, a soft mass, size of a small fist was found in the right lower lobe. An abnormal vessel, 6 mm in diameter, originating from the posterior diaphragm was found to the S¹⁰. Right lower lobectomy was carried out.
Gross pathologic examination showed grossly abnormal vessel entering the mass. The mass was a solitary cyst which was grayish-white, elastic firm and demarcated from the surrounding tissue.
Histologic appearance was characteristic of intralobar sequestration.

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