This communication described briefly the neuropathological changes found in 13 postmortem cases with carbon monoxide poisoning including 2 cares of intermittent form and of brains of cats experimentally subjected to CO poisoning.
The pathological findings we obtained were divided into two groups. The first group represents the diffuse lesions of incomplete necrosis in the cerebral white matter, and the second represents the lesions of softening in the cerebral cortex, globus pallidus, substantia nigra and Ammon's horn and necrosis in the granular layer and partial loss of Purkinje cells in cerebellum.
In favor of the exemplified results from the experimental study on cats, these neuropathological findings enable us to assume that the former group is counted to necessitated, particular change due to CO intoxication the feature of which is comparatively similar to those of edematous necrosis in the white matter, whereas the latter occasionally demonstrated as the sequelae of severe impairment of cardiopulmonary function. Subsequently, this may also link with deficient circulation as well as hypoxaemia in various ways in the brain as a possible pathogenesis.

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Fatigue in the work of nursing especially on the night-shift has tended to be discussed as an important problem in hospital management. For the purpose of its analysis, ten nurses who work for eight hours a day, the first day on the day-shift after a holiday and the following two days on the night-shift, were examined with the TAF test, flicker test (FF), esthesiometry (Es), dot-counting test (Dc) and cold pressure tent (CPT-Sw. D.).
Also the questionnare on subjective, feeling was given to the examinees together with the time study.
The pre-and the post-work values of the tests were compared to estimate the degree of the work load to the examinees, while the variations of the post-work values to the prework values were discussed for evaluating the differences between day-shift., the first night- and the second night-shift.
The conclusions were summarized as follows:
1. The degree of the physical load in nursing wore as calculated from the time study was rather light, with this assumption agreed the results of the function tests (FF, CPT and TAF), which indicated a higher or better level of post-work values after the day-shift.
2. A consideration that the changes of shift from day to night brought about a certain degree of caos in life rhythm which might result in mental stress to the nurses may be well accepted by observing the rate of fatigue feeling for the first night-shift was more than those for the other shifts and more in mental or neuro-sensoric aspect than in a physical one.
3. Continued night work for two days caused a significant decrease in the function tests (FF, CPT and FF) of the second night-shift in comparison with those of the dayshift.
From these results it cannot be determined whether the continuation of night-shift for more than two days may cause a further decrease in the function tests due to the accumulation of fatigue or, on the contrary, may give rise to a better function due to the adaptation to the changes in life rhythm.

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Pneumoconiosis and pulmonary tuberculosis have a highly close relationship each other and pneumoconiosis is liable to cause tuberculosis. Such case of pneumoconiosis with tuberculosis is mush malignant than the simple pulmonary tuberculosis and tuberculosis is said to give various influence to the prognosis of pneumoconiosis.
Recently, studies regarding pneumoconiosis have been developing rapidly, however, reports regarding calcium metabolism are quite few. Especially, reports on serum and organs at their certain time of period are obtainable but no reports are found regarding its state with lapse of time.
The experiment was carried out by using of rats of Wister lineage, which were administered by bovine type A. F. B. and minute dust, such as Quartz, Metallic Aluminium and Titanium Dioxide.
Minute dust and A. F. B. were injected solely or both at the same time into bronchus by bronchial tube. Following their progress after 11/2 months, 21/2 months, 31/2 months, animals were sacrified by means of heart puncture, and then the quantity of calcium in the serum, lung, spleen and muscles were estimated and also examined pathologically.
The results were as follows:
1) In the case of pneumoconiosis with tuberculosis, the amount of calcium decreased, while in the case of pneumoconiosis only the amount of calcium in serum or lung tissue is normal or slightly increased.
By naked-eye observation, there was a slight difference on the state of pneumoconiosis with tuberculosis, depending on the type of dust, and this was proved by microscopic examination.
2) The advance of tuberculosis in lung was ill-effected by minute dust, particularly by Metallic Aluminium and Titanium Dioxide. In the case of pneumoconiosis with tuberculosis, tuberculous foci were extended by the deposit of the dust. The time of formation of minute knot in the lung differs depending on the type of the dust. On the other hand, fine dust was influenced by the presence of tuberculosis.
3) The amount of calcium in serum and organ did not decrease in the case of pneumoconiosis only, while in pneumoconiosis with tuberculosis it decreased at the early stage of tuberculoss infection. However, att the time of recovery of tuberculosis there was tendency of gradual increase, which was depended on the type of the dust. Further, in the pneumoconiosis was tuberculosis, the amount of calcium in each organ decreased lower than that of the pneumoconiosis only, at the early stage of infection, but it would be subsequently increased gradually.

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For the purpose of evaluating the diagnostic value of the Takahashi test, a joint study was undertaken in patients with pulmonary tuberculosis who were under treatment in five national sanatoriums in Hokkaido. Periodical readings of the test were compared with the process and long-range outcome of the disease.
The study led to the following results:
1) In case of pulmonary tuberculosis, titers of the test were found to correlate to a high degree with types of disease, existence of cavities, culture positivity and disease activity. Little difference in correlation was noticed at the beginning, the sixth and the twelveth monthh of the experiment.
2) In patients who underwent surgical treatments, the Kaolin-titers became better in almost all the cases by six to nine months following operation, irrespective of the sorts of surgical treatment.
The improvement of Kaolin-titer was found best in successful resected cases without residual lesion, followed by resected cases with residual lesion and collapse-therapy cases; in the latter two cases the betterment was much alike.
In operated cases, the Kaolin-ctiterso incided with positivity and negativity in culture.
3) In case of primary treatment, patients tended to show a clear improvement of Kaolin-titer in course of the treatment.
4) Close relationship was found between Kaolin-titer and outcome of patients at the leave.
5) Again, close relationship existed between Kaolin-titer at the leave and outcome of patients from one and a half to three years afterward.
The preceding facts can be said to credit the Takahashi test with a high diagnostic value.

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The activities of two enzymes, creatine phosphokinase and transaminase in serum were measured in 34 cases of progressive muscular dystrophy. The enzymes were increased in the serum almost all patients with progressive muscular dystrophy in contrast to the other types of muscular atrophy.
The enzyme activities were found to be elevated particularly in the early stage, thereafter lowered at severely impaired stage. In the case of Duchenne type dystrophy this fact was evidently shown. The elevated activity of those enzymes was discussed in relation to some conceptions of the pathogenesis of progressive muscular dystrophy.

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The urinary creatine and creatinine were measured in 34 cases of progressive muscular dystrophy.
The increased excretion of creatine was observed in the patients with progressive muscular dystrophy and with other type of muscular atrophy. Even the creatinuria was demonstrated in other type of atrophy and normal human subjects, the output of creatinine in progressive muscular dystrophy was found to be lowered.
The decrease in excretion of creatine was found to correlate with the grade of severity (duration or muscular impairment) in muscular dystrophy.
The creatinuria was invariably encountered in all cases of chronic dystrophy. Pronounced excretion of creatine may physiologically occur even in not only normal subjects but pathological conditions not known to be associated with muscular disease.
Therefore, creatinuria should be less diagnostic for progressive muscular dystrophy.
The decrease in excretion of creatinine in progressive muscular dystrophy is more significant rather than increase in excretion of creatine in its diagnosis.
These results were discussed in relation to the concept that the urinary creatine in that disease represents the creatine newly formed in the liver from which the creatine would have faild to enter muscle.

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Recently Dowben reported that the administration of anabolic steroid and digitoxin was effective for the treatment of progressive muscular dystrophy. Following his method we tried to treat the dystrophic patients to re-evaluate his idea.
Eighteen patients (10 Duchnne, 6 limb-girdle and 2 facioscapulohumeral type) were given 4-hydroxy-17α-methyltestosterone (0.5-0.6 mg/kg/day) and digitoxin (0.01-4.012mg/kg/week in divided dosis). All the patients were examined by muscle testing and chronological serum creatine phosphokinase (CPK) determination. During treatment, the serum CPK revealed various changes, Only 2 of 18 patients (Duchenne and limb-girdle type) showed a remarkable decrease of serum CPK activities, with slight increase of muscle strength, however, a few months later CPK levels increased up to the pre-treatment level.
Eighteen patients (17 Duchenne and 1 limb-girdle type) were divided into 2 groups, the former given 4-hydroxy-17α-methyltestosterone alone and the latter, in combination with digitoxin. CPK levels were measuredd every 2 weeks. During treatment CPK levels were unchanged or slightly decreased for a few weeks and then abruptly increased up to twice of pre-treatment levels. This rebound phenomenon was observed in both groups but the time of rebound in the latter group was delayed about 2 weeks in compared with the former.
In the result, Dowben's treatment seems to be ineffective for muscular dystrophy, but the delayed rebound phenomenon of CPK in the latter group is very interesting from biochemical view point. The mechanism of the rebound phenomenon of the serum CPK is open to be clarified.

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Twelve cases of progressive muscular dystrophy, in which 11 cases of Duchenne type and 1 case of facioscapulohumeral type from 7 to 14 year of age were accounted, were subjected on this study.
Endocrinological study disclosed that Trisorb Resin Sponge uptake showed tendency of elevation in cases of higher degree of disability, and urinary 17-Ketosteroids decreased in most of cases.
Creatin phosphokinase, lactic dehydrogenase and aldolase showed decreased value in proportion to the degree of their functional disturbance.
Excercise with the intention of discipline had better influence on pulmonary function and circulatory state, and improved their disability by combined orthopedic treatment.

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(1) The affection of bone and joint in tuberculosis gives no serious influence on the menarche, menstrual circle, menstruated period and menostasis.
The small amount in menorrhoea, however, are elicited in 44 cases (24%) out of 239 cases on questionair.
This may be induced by the chronic consumption caused by the tuberculosis of bone and joint.
(2) If the orthopedic treatment is still insufficient, with the manifestation of cyst like decalcification, atrophy around the residual bone debris, and clean-cut sequestrum on Xray findings, even the artificial delivery, though aiming the less consumption, causes the aggravation or relapsy of the tuberculosis.
(3) Provided the focus is in sound stillness, artificial or even natural delivery gives no influence on the tuberculosis regardless the involevement, extent of focus and vertebral deformity.
(4) The combination of the narrow pelvis is observed in high frequency in the female patient with the spondylitis tbc.
24% out of total cases with the normal developement of foetus, is to be on Cesarean Section on her delivery.

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