Fourty-six cases of trophoblastic tumor were experienced in our Clinic from 1951 to 1963. All cases were re-examined histologically and classified into chorioepithelioma, chorioadenoma destruens and undetermined group. 24 cases of chorioadenoma destruens were confirmed histologically and macroscopically by the presence of well preserved villi in the uterine muscle or parametrium. 13 cases of chorioepithelioma were diagnosed histologically. The remaining 9 cases could not be confirmed histologically, because the trophoblastic growth was not found in all removed specimens, or the amount of trophoblastic tissue was too scant to confirm the disease.
But all cases were diagnosed as trophoblastic tumor chorioepithelioma or chorioadenoma destruens by the presence of metastasis. The survivals over one year after surgery, whose pregnancy test continued negative, were 75% in chorioadenoma, 61.5% in chorioepithelioma and 66.7% in undetermined group. When 3 cases of undetermined, which were clinically supposed as chorioepithelioma, are added to chorioepithelioma group, its survival rate are reduced to 50%. 16 cases of 24 chorioadenoma, 7 cases of 13 chorioepithelioma and 5 cases of 7 undetermined group developed after hydatidiform mole.

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The treatment of threatened abortion has been performed almost always by means of hormone therapy centering around progesterone although effectiveness of this approach is doubted by some workers. It is hard to determine whether the given case of threatened abortion is indication of the hormone treatment, however, at the present time in consequence of absence of better therapy, we have to employ this hormone therapy. Chlormadinone acetate shows the strongest luteinizing hormone activity with little side effects, that is suitable for clinical use against threatened abortion. It has been abministered in doses of 6 to 12mg daily for 10 days by the oral route. The following results were obtained by clinical use:
Hemorrhage from the genitalia improved in 8 out of 17 cases by days after the onset of treatment. Hypogastric pain disappeared in 5 out of 9 cases by 5 days. Pregnancy could be maintained in 10 out of 14 cases whose B. B. T. had been elevated or consistently high.
Urinary pregnanediol levels in all cases with the progression abortion were as low as 3mg/day or less, while the said levels tended to rise gradually in the cases maintaining pregnancy. Pregnancy was maintained in all the cases whose vaginal smear showed the pyknosis coefficient of 15% or lower.
After all, the administration of Chlormadinone led to improve the abortive symptom in 12 out of the 17 cases. The drug produced no side effect in the pregnant women and their fetuses.

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The lymphographic study was made on 70 cases of genital cancer. The results of pathologic studies on 33 patients who had lymphadenectomy and post mortem studies were exactly correlated with the lymphographic findings. Metastatic changes of lymph nodes were verified by histologic examination in 8 cases, the lymphograms of which were estimated as positive for metastatic involvement. The histology of the rest of them (25 cases) had no metastatic changes but these lymphograms revealed various findings suspectable of pathological changes. n the other 37 cases which were clinically but not histologically proved of metastatic changes of lymph nodes, variable similar findings were also obseved on lymphograms.
In the cases with metastatic involvement of lymph nodes, the characteristic malignant patterns such as filling defects, irregular contour and inhomogenous artitecture were noted, moreover, an increase in number and size were observed. These findings are frequently found in inflammatory process.
In the lymphatic system with extensive involvement, however, passage disturbance is often found with changes of lymph vessels such as dilataton, tortuosity. back flow, collateral, detour, oozing and an increase or decrease in number.
False positive findings of lymph nodes, resulted from inflammation, fibrous fatty deposit or ococcasional super imposition of lymph nodes are frequently encountered.
Because the postoperative lymphogram reveals so variable that it is difficult to diagnose whether these patterns depend on lymphadectomy or reccurrence and also hard to investigate the etiology of secondary edema, the differentiation of these patterns have to be made by both lymphography and venography.
Lymphography was usually performed prior to radical operation as a guide for nodal dissection, to search the gross metastatic extent of genital cancer and at the same time the application of PTCHLO (pure natural chlorophyll oil) with oily contrast medium (Ethiodol or Poiodol) made it easier for gynecologist to identify lymph nodes at the operating table.
Controverting the some authors, the obturator in most cases, the hypogastric in more than a half, and sometimes the cardinal ligament and the sacral lymph nodes were greenly stained.
In setting up the portals for radiation therapy, lymphography was beneficial to place various portals and recently we adopted a diamond-shaped field (12×12cm-14×14cm).
Postlymphographic complications were observed in high incidence, these were pulmonary embolism, fever chillness, inappetence, fatigue, cough and sputum. Although microscopic metastatic lesions were usually not detectable by this technique, the lymphography is to be said a nssesary procedure to examine malignant tumors, especially lymphatic tumors showing certain specific features.

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As there is no unanimous coincidence of opinions about the critical concentration of the secondary drug resistance, we have studied on 251 cases of severe pulmonary tuberculosis, who were always discharging the tubercle bacilli and became almost all resistant to the primary drugs.
The resistance test was carried out on 3% Ogawa medium containing the drug of concentration 0, 50γ, 100γ, 1000γ for kanamycin (KM), 0, 25γ. 50γ, 100γ for Ethionamide (TH) or cycloserin (Cs). Although the absorption of KM by egg medium was shown by many authors, we didn't think that it was necessary to know the true value of the drug in the medium in connection with resistance test. Moreover we experienced better coincidence of resistance grade by the Ogawa medium than by the agar medium, when the study was executed in 24 different institutes on 10 different tubercle bacilli stems at the same time. The size of the inoculum was about 10^-3mg, but the growth on the control was not necessarily the same. The value of Cs or TH in the Ogawa medium decreases with the prolongation of the preservation days, the higher the temperature, the more it was damaged rapidly. From this study, we used the media at least within two weeks after they were made.
Among the patients who didn't yet receive the secondary drugs, the sensitive cases to 25γ were found in 51.5% for TH, and in 48% for Cs. The cases to sensitive to 50γ were found in 91.5γ for KM, in 83.7% for TH and in 82% for Cs. Accordingly we adopted any growth on 50γ as a critical concentration of the secondary drug for the present, although the resistance grade of one patient was not necessarily the same during the course of the treatment, even if he didn't receive any of the secondary drugs.
The conversion rate was parallel to the grade of the lung destruction, and the number of discharged bacilli, It was better when the patient was treated with combined two or more secondary drugs than with only one drug, in latter cases, the primary drugs became already resistant, were always combined.
The conversion rate of 89 cases treated with one of the secondary drugs which were sensitive to 50γ, was 16%, on the other hand that of 27 cases resistant to the drug was only 7%.
Among the cases treated with combined two secondary drugs, in 48 cases sensitive to 50γ the conversion rate was 41%, in 20 cases resistant to one drug it was 30%. and in 6 cases all resistant it was only 16%. The period of the appearance of the resistance was eariest with TH. and slowest with Cs.
There were several cases who didn't become resistant to 50γ, when the bacilli of sputum inrceased again, after they became negative or decreased. This means that the critical concentration of the secondary drugs could be lower in these cases,

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(1) A method for testing reliability of the drug resistance test has been proposed. The method consists of observing at what per cent the test to be tested fulfils the following two conditions: (1) Strains of tubercle bacilli from untreated patients are to be read as “susceptible”; (2) Strains of the patients treated with a single drug for six months are to be read “resistant”
(2) Taking an appropriate “critical concentration”, a simplified method has been tested for routine use. The method consisted of inoculating simply one loopful of the test maetrial onto a medium containing the critical concentration of drug. Reliability of the method has been tested by the above method.
Simplified tests for kanamycin resistance and cycloserine resistance proved to be sufficiently reliable for the practical use. On the other hand, such method for ethionamide resistance test proved to be less reliable. The following critical concentrations have been suggested to be suitable; 25 or 50μg/ml kanamycin; 25 or 50μg/ml ethionamide; and 25μg/ml cycloserine in Löwenstein-Jensen medium.
(3) Ethionamide delayed the emergence of cycloserine resistance in tuberculous patients and cycloserine delayed the emergence of ethionamide resistance.
Kanamycin delayed the emergence of ethionamide resistance in tuberculous patients, whereas ethionamide did not delay the emergence of kanamycin resistance. Cycloserine did not delay the emergence of kanamycin resistance.

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A group of 149 patients with cultures resistant to one or more of the primary antituberculosis drugs was treated with the secondary antituberculosis drugs for 6 months or more.
Of whole patients 25.8% became sputa negative on smear and culture.
Of the patients treated with secondary drugs in combination with primary drugs 26.8% became negative.
In the group treated with three drugs 34.8%. and with two drugs 15.6% became negative. Three drugs treatment is more effective than two drugs.
One group had one secondary drug in combination with two primary drugs and 29.8% became negative. Another group had two secondary drugs and one primary drug and 45% became negative. The third group had three secondary drugs only and 44.4% became negative.
One group of streptomycin resistance patients was treated with one of the secondary drugs in combination with isoniazid and PAS, and 16.8% became negative. Another group of streptomycin resistance patients was treated with two secondary drugs in combination with isoniazid and 40% became negative.
The 33 patients treated with secondary drugs for 6 months and had positive cultures had been continued to have same treatment for 8 to 12 months length and only one of them beame negative. The 14 patients who became the sputa negative had been continued to have same treatment and 5 of them became again positive.
In the first treatment group with the secondary drugs 30.4% became negative, and in the re-treatment group 20.3% became negative. First treatment was better than re-treatment.
Radiographic improvement occured in 13.4% of noncavernous diseases, and in 10.5% of cavities.
Treatment was interrupted because of drug toxicity in 16.1% of the whole patients. In this series pyrazinamide has been stopped because of toxic effect in 27.8% of cases, ethionamide in 15.4%. cyclocerine in 8.3%, and kanamycin in 1.7%.
Joint-pain by pyrazinamide, jaundice by ethionamide, aberration by cyclocerine were most unpleasant symptomes to patients. One patient with jaundice by ethionamide died. These toxic effects are abstacles of treating patients wtih the secondary antituberculosis drugs.

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Sixty-four cases of inpatients were subjected in this study, in which the secondary antituberculosis drugs and both the primary and secondary drugs were used.
Most of them had been treated already for over three years and became resistant against two or three kinds of drugs.
We examined 31 cases of C type and 17 cases of F type in T. H. and the primary drug treated group, 5 cases of C type and 3 cases of F type in K. M. and the primary drug treated group, and only the secondary drug treated group.
There was improvement on extension of focus in 10 cases of C type and 2 cases of F tyep in T. H. group and in 2 cases of C type in K. M. group, but there was no sign of improvement in F type in K. M. group. There was improvement in 4 cases of C type by the secondary anti-tuberculosis drugs, but no improvement in F type. As to the effect to the cavity, there was improvement in 11 cases of C type and 3 cases of F type in T. H. group, in 2 cases of C type and one case of F type in K. M. group, and in 2 cases of C type by the secondary anti-tuberculosis drugs, but no improvement in F type.
In 5 cases of C type and one case of F type in T. H. group A. F. B. became negative.
In one case of each C and F type in K. M. group, A. F. B. decreased in its number. By the secondary anti-tuberculosis drugs two cases became A. F. B. negative.
Fifty-three of 63 patients complained some side effects. Many cases in T. H. group complained of discomfort of stomach.
As a conclusion it is noted that there was improvement in x-ray findings and effectiveness on A. F. B. negativity in sputa by the secondary drugs even on the cases who were reresistant against primary drugs and were hardly treated by the long period of chemotherapy.

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The incidence of hepatitis after blood transfusion has been increasing for the past few years, and quite a few preventive measures were reported. In order to avoid serum hepatitis after blood transfusion, surgical treatment of pulmonary tuberculosis without blood transfusion was performed on 41 cases from December of 1963 to June of 1964.
Analysis of these cases reveals as follows:
1) When the loss of blood was less than 15cc per kg of weight, most cases could be subjected to pulmonary surgery without blood transfusion. Patients had the uneventful postoperative recovery and have not suffered from any complication up to the date.
2) The examination of the blood revealed anemia during the first two weeks, however complete recovery occured within two months after operation.
3) No hepatitis has occured postoperatively.

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In the previous report authors tested the agglutination reaction between human sera and the formalized tubercle bacilli grown on the modified Ogawa media containing 3% of Tween 80 and suggested the effectiveness of the reaction in the diagnosis of tuberculosis. The present authors have, then pursued the further tests to clarify the mechanisms of the bacterial agglutination on the standpoint of serological specificity on the one hand and to improve the technical method of the test among at a practical application on the differential diagnosis of non-tuberculous chest diseases on the other.
Following conclusions were drawn from the experimental resluts:
1) Three healthy children under 1.5 years of ago who had not yet been injected with BCG living vaccine were just able to show the negligibly positive reaction to our test. However, markedly high agglutinin titers were recognized in sera of 4 children in good health within a year after the BCG vaccination.
2) Comparative agglutinin titers were checked in the immune rabbit serum before and after the absorption tests with bacterial cell cultures, and the successive diminution of titers was seemingly explained as a result of the specific absorption.
3) Middlebrook-Dubos' and our agglutination tests were performed at the same time, in double blind conditions, in immune rabbit sera as well as in human sera taken from tuberculous patient and healthy non-tuberculous controls. Strong parallelism was established, consequently, between the agglutinin titers of both tests.
4) Thus, the bacterial agglutination test were carried out in human sera separated from 34 patients suffering from non-tuberculous chest diseases in order to clarify the applicability of the test as a kind of supplementary diagnostics, followed with the practically hopeful results.

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1) Yatabe Guilford personality inventory test and vocational aptitude test edited by the Department of Labour were performed to 461 male patients and 254 female patients. Those patients varied in age from 20 to 45 years and were admitted in 14 national sanatoria which participated in joint study.
2) The patients were divided into two groups, rehabilitation and non-rehabilitation, according to the extent of participation in rehabilt ation programs at sanatorium. Difference of mean value in all scores of Yatabe Guilford personality inventory and vocational aptitude test of two groups was statistically analysed.
3) Significant difference between two groups was found in 8 scores of personality inventory of male patients (Co-operativeness, Objectivity, Nervousness, Inferiority, Ascendance, Emotional Stability, Depression & Social Extraversion) and in 4 scores of female patients (Inferiority, General Activity, Emotional Stability & Depression). It was generally recognized that the personality of patients who were classified into Rehabilitation group were adaptable for social environment.
4) According to the statistical analysis of vocational apti ude test, no significant difference was found between Rehabilitation group and non-Rehabilitation group.

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The author reported 3 cases of perplexing reaction by application of PAS.
Two patients had remittent high fever with chill, and another one had causeless subfebrile temperature rising. Leucopenia with comparative lymphocytosis was found in all cases, and 2 cases showed eosinophilia.
But these phenomena disappeared dramatically by the stoppage of PAS. After then, 2 cases received desensitization by applicaltion of minimal dosis with gradual increase.
One case tested by the Leucocytolysis Test of Favour, which confirmed the existence of the reagin.

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