Reliability ultrasonic examination for the diagnosis of cholelithiasis was evaluated in cases which were observed during the period from April to December, 1966.
The apparatus employed is the ECHO-Trace ultrasonic analyzer, ALOKA SSD-II (A-scope), manufactured by I.R.C, Co. The frequency rang was 1 to 5 M.C.
The material consisted of, 43 cases with a positive stone echogram, which were operated on under a preoperative diagnosis of cholelithiasis.
The findings of ultrasonic examination of the cases were compared with the findings of physical examination, cholecystography and the operative findings.
The 43 cases were classified into the following three groups according to the findings; group A, cases in which presence of gallstones were demonstrated radiographically (17 cases); group B, cases in which presence of gallstones were not demonstrated radiographically(18 cases); group C, cases in which gallstones were not found at operation(false positive diagnosis of echogram, 8 cases).
Thus, the number of correct diagnosis in cases with positive echogram was 35 out of 43, i.e., 81.4% while there was a great percentage of false negative cases in cholecystography for the diagnosis of gallstones(18 out of 35, i. e. 51.4%).
Sourses producing patterns simulating stone echogram appeared to be as follows;
1) Echoes from proliferations and adhesions due to duodenal ulcer;
2) Echoes from proliferated gallbladder wall;
3) Echoes from malignant or benign neoplasms, or inflammmatory scars . at the bile duct;
4) Multiple echoes from the abdominal wall, echoes from gases in intestines, and echoes from the diaphragm or liver edges.
From the above results, it may be concluded that ultrasonic examination is a diagnostic method better than cholecystography for the detection of gallstones.

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EEG has been recorded on all diabetic cases who have been seen at the Medical Department of the National Kure Hospital for 3 years. Of the cases, 147 male and 105 female cases totalling 252 other than those complicated with diseases considered to cause EEG abnormalities such as epilepsy, endocrine disease and liver disease were reviewed by
comparing EEG with clinical findings, and the following results were obtained.
A) Remarkable slow wave (paroxysmal high amplitude slow wave) was noted in 27 (37%) females, and slow wave was noted more often in females than in males.
B) Abnormal wave was often noted in diabetics under 29 years of age.
C) Leg pallesthesia was disturbed in 54 of 104 cases, and abnormal EEG was often notedd in those with disturbed vibratory sense.
D) Abnormal knee jerk was noted in 120 of 197 cases. Those with absent knee jerk. often showed abnormal EEG, and those with normal knee jerk, normal EEG.
Leg pallesthesia, knee jerk, and EEG were regularly determined once a week with. the course of diabetes.
In many cases, leg pallesthesia got worse transiently 1 or 2 weeks after the commencement of treatment and it often decreased especially in those whose blood sugar level had promptly become lowered by treatmen.
Subsequently, the sense gradually became recovered by continued treatment. In some cases, slow wave component increased transiently in an early stage of treatment. Generally, however, by continued treatment, EEG showed an increase of α- band and a decrease of θ-band. Knee jerk gradually became improved by treatment.
The transient aggravation of EEG and leg pallesthesia in an early stage of treatment way be due to the lowering of blood sugar level prior to the improvement of diabetic state.

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We studied on postoperative non-tuberculous compications following thoracic surgery. It is recognized that this complications occur on 26 cases in total 209 operations (12.4%).
The results is as follows.
It is notable that 15 of 26 cases (58%) had had their complications preoperatively.
We found that the postoperative serum hepatitis occured on 84 cases (43 %) among all transfused 194 cases.

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The amyloid tumor of the larynx is an uncommon pathologic condition and it was first reported by Burrow and Neumann in 1875. In Japan the first case was reported by Kuroda and Kondo in 1940.
The disease occurs most commonly in the fifth decade of life and men are afflicted more frequently than women in a ratio of 3 to 2 of 25 out-patients in our hospital from 1960 through 1966.
In our cases the amyloid tumor is found in the hypopharynx, bilateral vocal cords, subglottic space, and oftenest in the right vocal cord. Hoarseness is the most frequent symptom, the duration of which varies from a week to one year.
The diagnosis is established by excisional biopsy.
The surgical procedure is the only effective treatment for the isolated, tumor-like forms.
In histopathological examination of our cases based on their strain properties, the amyloid tumor is considered not to be the true amyloid, but the deposit of fibrinoid material caused by chronic inflammation.

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The author had become to suspect on the utility value of the histological classifications of the breast cancer, now accepted in the world, everytime by the patho-histological examination of the breast excised surgically due to cancer, and then had attempted to appreciate on their appropriate use.
There are many histological classifications of the breast cancer designed by those authors as Kaufmann-Gruber, Geschickter, Willis, Stewart, Kuzuma, Ackerman, Arbertini etc., with each own criteria. Recently WHO international reference center for mammary tumors published another one in 1964. In those classification tables the classification terms are
selected usually corresponding to the histological variants of the breast cancer.
The author has been convinced that a classification term of breast cancer should be responced to a species of cancer.
On this viewpoint the author studied on the histological classifications designed by those authors as described above, and noticed, for example, that the classification terms listed in the Stewart's classification table or the terms listed as special histological variants in the WHO classification are mostly corresponded to the histological variants of the breast cancer.
The tranceferences between the variant histological pictures observed in the breast cancer are often noticed. The histological pictures of the breast cancer are influenced significantly by the conditions surrounding cancer tissue as cystic dilatation of mammary ducts, lobular or ductular hyperplasia, interstitial hyaline fibrosis etc., when cancer tissue pro-
liferate within them. These facts signified that the histological classification terms of the breast cancer, above described, don't represent the species of the breast cancer but merely the variances of histological pictures. The author concluded that the histological cla-
ssifications of the breast cancer, now popular in the world, should not be used for representation of the breast cancer but for description of the histological variances of it.
The hospital pathologists, who have been examined pathologically the excised breast due to cancer routinely, shall have to be expected for the reports such as the diagnosis of cancer, its invasiveness and metastasis, and the suggestions upon the sensitivity of the breast cancer cells for radiation or antineoplastic drugs. For those purposes the author
designed a practical rule of the pathological examination of the excised breast and of the description. The author offered a opinion that the further studies on the sensitivity of breast cancer cells for radiation or antineoplastic drugs and on the host resistance should be encouraged strongly.

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(1) This paper concerned with a technique and results of postoperative tele-cobalt therapy for 77 cases of breast cancer, who passed at least one year after the beginning of the treatment.
(2) Two radiation fields were chosen.
The chest wall, including the operated area and internal mammary chain, was irradiated by the tangential technique, in which edge of the radiation beam passed through the diseased side of the posterior axillary lines and the healthy side of the parasternal line.
The other radiation field contained the axillary, supraclavicular and subclavicular region of the diseased side, inclining radiation beam about 15 degrees capitally. A tumor dose of 5000R was administered through each field.
(3) Survival rate of 77 cases who treated by our irradiation technique was as follows;
One year survival rate was 93.5%, two year survival rate 88.0% and three year survival rate 78.3%.
No severe injurious effect on the lung, heart or bones after irradiation have been observed.

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The early breast cancer which was non-infiltrating carcinoma without axillary lymphnode metastasis were summed up.
From 1953 to August 1966, 35 cases of the early breast cancer came to our clinic of the Kanazawa National Hospital. It was estimated that the frequency of the early breast cancer among our 368 cases of all breast cancer was 9.5%. The youngest patient was 20 years old, and oldest one was 65 years old. While the mean age of all breast cancer was 47.9 years and that of the early breast cancer was 38.7 years.
The length of time elasping between the patient's recognition of the symptom and her visit to the clinic was less than 6 months in about 71.3%, except one case who was so young that she had waited over 1 year before consultation.
As the symptom, tumor was palpable in most cases, and $ cases (22.9%) were presented the haemorrhagic nipple discharge.
The Iocalization of the pathological lesions was over-lateral quadrant of mammary region frequently, but the bleeding from the nipple was found to the beneath or adjacent to the nipple.
The histopathological diagnosis on all of 35 cases of the early breast cancer was intra-Iuctal carcinoma, and no case of lobular carcinoma in situ was found. It was interested that the patient of the early breast cancer associated with mastopathy was presented in 91.4% (323 cases) of our 35 cases of the early breast cancer.
All of them were performed the radical mastectomy, and have been survived without the local recurrence or the distant metastasis.

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Recently, roentgenography of the breast provides a new approach to study of the breast. But accurate diagnosis of the breast depends upon a good quality of the roentgenogram.
For this purpose, we studied mammography by using Toshiba, KXD Model 15 and special take, DRX 20A(pw), and concluded as follows:
1) Thin glass window X-ray take, DRX 20 A(pw) was better than Be window take.
2) The roentgenographic cone should be used in mammographic examination, because we protected the patient from excess exposure.
3) Standard technic in Sagamihara National Hospital as follows. 28-32 KVp. 100-300 mAs, FFD60-70cm, Sakura-Industrial RR.
4) By using intencifying screen the X-ray dose is able to decrease to 1/2. Screen method does not give any influence on mammogram.
5) The thickness and shape of breast on X-ray film give much influence upon the examination of mammography,

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Albumin metabolism was studied with the use of radioactive iodine (¹³¹I ) labeled human serum albumin (RISA) in patients with pulmonary tuberculosis and influences of synthetic protein anabolic steroids to albumin metabolism were considered.
In young patients with pulmonary tuberculosis the half-life of albumin was found to be shortened, and both its metabolic rate as calculated from urinary ¹³¹I excretion rate were increased, as compared with those in young healthy subjects. In spite of remarkable accelerated albumin degradation both the total exchangeable albumin pool and the extravascular albumin pool were not increased significantly in 2 cases. However in the other one case both the total exchangeable albumin pool and the extravascular albumin pool did markedly rise with the increased degradation rate.
The administration of synthetic protein anabolic steroids to one young patient with discrepancy between albumin degradation rate and total exchangeable albumin pool prolonged the albumin half-life, reduced the albumin degradation rate and increased both total exchangeable albumin pool and extravascular albumin pool. The accelerated albumin turnover in this case may be reduced to almost equal that in young healthy subjects by protein anabolic steroid therapy.
Two senile patients with pulmonary tuberculosis showed a reduction in total exchangeable albumin pool, extravascular albumin pool and albumin degradation rate, and the albumin half-life was prolonged. The data indicate that both the degradation of albumin and its synthesis delay at old age of the patients with pulmonary tuberculosis. But in the other
one case the total exchangeable albumin pool was slightly increased and the albumin degradation rate was almost equal to that in young healthy subjects despite of slow turnover rate.
In aged cases, who were treated with synthetic protein anabolic steroids, the albumin half-life was shortened, its turnover rate was accelerated, and the total exchangeable albumin pool and extravascular albumin pool were markedly increased together.
The results of studies on albumin turnover during the therapy suggest that both the albumin degradation rate and the total exchangeable albumin pool in senile patients are increased to be equal or more than those in young healthy subiects by protein anabolic steroids.
Moreover the effects of protein anabolic steroids to the tuberculoss lesion in their pulmonary fields were discussed.

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We isolated 62 staphylococci and 174 Gram-negative bacilli from sputa of the far advanced paimonary tuberculosis patients four times during the period of January to December, 1956. We compared these germs so-called “carried strains” with 150 strains isolated from infectious foci of non-tuberculous patients in our hospital from January, 1964 to December, 1965, and we carried out the sensitivity tests of these two groups of strains.
Results:
1) There is no difference of staphylococci a ndGram-negative bacilli carried by 50 pulmonary tuberculosis patients between four occasions of examination. They carried Staphylococci 32.3%, E, coli 28.6%. Klebsiella 27.6%, Proteus 12.5%, Pseudomonas 8.8% and the others 12.9% in total 192 patients during one year period.
2) In four times' examinations with the lapse of time, the number of patients whocarried the same germ more than twice in succession was 15 in Staphylococci, 13 in E, coli, 9 in Klebsiella, 5 in Proteus and 4 in Pseudomonas. The number of the patients who showed the same resistance Pattern was 6 in Staphylococci, 6 in E, coli, 4 in Klebsiella, 2 in Proteus and 2 in Pseudomonas. Each germ was carried over a few months at the rate of 40-50 per cents.
3) A trend of antibiotic resistance of above mentioned 62 strains of Staphylococci could be observed. The resistance to PC and SX showed the highest percentage. The incidence of the strains resistant to SM was about 50%. They had the high sensitivity to CP, TC and KM. There was no difference between so-called carried strains and the strains obtained from inpatients and the tuberculosis patients, judging from the resistance to PC, SX, SM, EM and KM out of seven antibiotics. The carried strains, however, showed a higher resistance rate to antibiotics than outpatients and patients of non tuberculosis cases. The carried strains had the same trend of the resistance to one or two antibiotics as the strains obtained from inpatients and tuberculosis patients.
4) we recognized that the strains which were obtained from outpatients and patients of non tuberculosis cases showed the resistance to PC for the most, judging from the resistance pattern. Next this resistance proceeded to SM. But the resistance of the strains obtained from inpatients and tuberculosis patients proceeded mainly from SM to EM by way of PC. The carried strains proceeded between the above mentioned two patterns. It was considered as the first stage of development of resistance to KM that “PC-KM resistance pattern” was observed in the carried strains.
5) The sensitivity of carried Gram-negative bacilli to antibiotics-PC, SX and EM-was found extremely scarce. The incidence of antibiotic resistance of this germ was more than 76%, except for E, coli 58.1%. E, coli showed a comparatively low rate of resistance to CL, KM, just as Pseudomaonas to CL. The rate of Proteus resistance to SM was 45.8%, and this germ showed the resistance to seven antibiotics more than 55%. Observing the resistance to various kinds of antibiotics-as far as SM, CP and TC were concerned-we noticed that Pseudomonas showed the highest resistance rate of 41.1%, secondarily E. coli showed 21.8%.

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Using “Triosorb diagnostic Kit, ” the thyroid function test with ¹³¹I-T₃ resin sponge uptake was performed for more than 100 sera.
The following results were obtained.
1) Results of the test were as follows : 26.0-39.0% (average 33.0±31%) for 10 normal subjects ; 42.0-68.0% (average 51.8±5.9%) for 22 cases with hyperthyroidism; 25.0-39.0% (average 31.8-3.9%) for 33 cases with simple goiter; 17.0-26.0% (average 22.1±2.8%) for 5 cases with hypothyroidism; 20.0-25.5% (average 21.8±1.0%) for 10 cases with normal pregnant women; 42.0-48.0% (average 43.5±2.5%) for 10 cases with nephrotic syndrome
in acute stadium; 35.0-43.0% (average 35.0±2.1%) for 5 cases with liver cirrhosis; 52.0% and 58.0% for 2 cases with multiple myeloma.
2) The mean value of normal non-pregnant women was 31.2±3.1% a week before menstruation; 31.6±2.8% during menstruation; 31.7±2.1% a week after menstruation, the variation with menstruation cycle was not significant.
3) The test was compared with other thyroid function tests. The test demonstrated a significant parallelism with ¹³¹I-T₃ red cell uptake and PBI. But, the test showed a poor parallelism with ₁₃₁I-thyroidal uptake and basal metabolic rates. The test demonstrated less overlapping of the results among hyperthyroid, normal and hypothyroid subjects in comparison with ¹³¹I-thyroidal uptake and basal metabolic rates.
4) In cases with hyperthyroidism, results of the test obtained before and after the treatment demonstrated a significant parallelism with clinical symptoms and other laboratory data. Not influenced by exogenous iodide, it is very useful in post-therapeutic observation of patients after ¹³¹I, anti-thyroid agent and thyroid extracts were given.
It can be done without giving ¹³¹I to patients, and needs only a few milliliters of patient's blood, and further it is extremely simple and safe. It is very helpful in diagnosis and treatment of various thyroid diseases.

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The studies were made on the present status of admitted patients with pulmonary tuberculosis, 209 in number, in Akita National Sanatorium, and on the causes of faradvanced cases.
The result were as follows:
1. The age of admitted patients changed evidently into middle and old aged class.
2. Among these patients, 38 per cent were expected discharge from sanatorium by improvement, but 44 per cent were not.
3. The cases which were not responded to treatment and were expected discharge, were observed in 78 per cent of the group of F and G₂, ₃ KY₃, Z type by Gakken's
classification at hospitalization. But a few patients fell into such severe types from other types too.
4. Those severe types were observed most frequently in the cases which were discontinued the initial chemotherapy, or treated for less than 6 months bofore hospitalization, or passed through more than 2 years after the onset.

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NaHCO₃ and TRAM are often used as alkalizing agents in treatment of acidosis. THAM is characterized as effective in combined cases of respiratory and metabolic acidosis, and non-ionized part of that goes easily into the cell and alkalizes the inside of the cell.
The dosage which should be given to the patient with metabolic acidosis had been calculated by the formula (BE×body weight (ml) ), but to use Base Excess as an index of acidosis is not always proper, because Buffer Capacity is not equal in normal, hypoproteinemic and anemic blood.
So author devised the better formula which can be clinically applied more reasonably, which is “THAM (mEq)×0.7 =3×BC×Δst, pH×W”.

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