1). Regular ophthalmoscopic examination was conducted in the prematurity ward in the National Children Hospital in Tokyo from Sep. 1965 to Aug. 1966 with a view to detect the retinopathy of prematurity.
Out of 78 premature infants studied, 13 cases developed retinopathy of prematurity. Spontaneous regression or improvement by treatment took place in 8 cases with initially active disease, while the remaining 5 cases healed with extensive scar formation. The incidence of retinopathy was inversely related with the birth weight and was frequent found in cases who showed prematurity fundus characteristics which are more closely described in the text.
2). 40 cases with retrolental fibroplasia of cicatricial stage were detected in the policlinic and were studied for the visual and ocular defects. Eyes affected with severe retinopathy of grade IV or V were invariably blind, while those of grade II or III had handicapped vision ranging from 20/30 to 3/200. Myopia or myopic astigmatism were often associated with mild or moderate retinopathy of prematurity.
In eyes with grade II retinopathy tempolar scars may produce heterotropia of the macula which results in pseudo-exotropia.

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We examined neutralizing antibody for M. pneumoniae. in 106 healthy person Proportion of the antibody positive rate was higher in fourth decades (64 per cent) than in infants and children (20 per cent). Using diphasic media 8 strain of the agent were recovered from 38 patients with respiratory diseases, most frequently in atypical pneumonia.
In this three-year study 19 of 72 (26 per cent) cases with atypical pneumonia of adult had serological evidence of Mycoplasmal infection by CF test, while cold agglutinins developed in 21 cases (29 per cent). 14 of 21 cases with positive cold agglutinin had evidence of Mycoplasmal infection.
Mycoplasmal pneumonia was found frequently in spring and early summer. Many of them occured in second decades and rarely over fifth decades. Cough and fever were most predominating symptoms. Body temperature was 38.6°C and duration of fever was 5.7 days. Physical findings in the chest were mild. On x-ray examination involvement of unilateral lower area was seen in 60 per cent of the case, and this findings disappeared in 23 days. The sedimentation rate was markedly elevated. The white blood cell count was mostly remained normal.

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1) Diabetic ketosis and semicoma:
In 34 year old diabetic man with semicoma, ketonemia and hyperglycemia (1400mg/dl), 500ml. of 5% solution of xylitol was administered with 100 unit of Actrapid insulin. Diabetic ketosis disappeared on the next day and diabetic state stabilized.
2) Diabetes with pyelonephritis, high fever and weakness:
In 61 year old diabetic man with high fever and deterioration of diabetic control, 1000 or 500ml of 5% solution of xylitol was infused for a week with some antibiotics and improvement was observed.
3) Diabetes with chronic hepatitis or drug induced hepatitis:
In 39 year old diabetic man and 53 year old woman with liver disease SGOT, SGPT and ICD were improved after the administration of xylitol for one month and three monthes, respectfully.
4) Myocardial infarction with diabetes mellitus:
In 63 year old diabetic man complained of severe chest pain whose electrocardiogram showed infarction curve, 500 or 1000ml. of 5% solution of xylitol were infused for weeks everyday. Parenteral administration of xylitol caused no deterioration of diabetic state and rather it brought improvement of myocardial infarction.
5) Clinical effect of xylitol on surgical operation:
In 58 year old woman and 68 year old man with diabetes mellitus surgical operation were perfomed because of gastric cancer.
500 or 1000ml. of 5% solution of xylitol were infused to these patients before, during and after these operation. Deterioration of diabetic state was avoided.
6) Liver disease without diabetes mellitus:
In 57 year old man with liver cirrhosis ascites disappeared after administration of 10% 500ml. of xylitol everyday for several weeks.
7) Cancer:
Cancer of stomach with liver metastasis and ascites was treated with endoxan 200mg. dissolved in 500ml. of 5% solution of xylitol everyday for one month, and ascites disappeared and SLDH decreased. Passage of meales became easy and he could get up and walk. But 2 months later, his leucocyte count decreased and he died of pneumonia. Xylitol may increase the action of endoxan.
8) Diabetic retinopathy:
Parenteral administration of 20ml. of 10% solution of xylitol for one month everyday improved diabetic retinopathy in 4 of the 11 diabetic patients.

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Recently, 115 cases of duodenal diverticulum were detected among 6787 cases which received radiological examination on upper gastrointestinal canal.
These cases indicated that detection of duodenal diverticulum might be increased by means of combination with several radiological method, especially so called “double contrast method”.
Probably, it might be caused by summation of weakness and addition of angiosklerotic changes in intestinal tissue that numbers of cases of duodenal diverticulum (maximal peak was in the generation from 50 to 60 years old) and size of diverticulum increased by progression of age.
Many cases were symptomless, but a few cases which had larger diverticulum were suffering from some symptoms (epigastralgia, hypochodralgia, etc.) on epigastrial region.

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The increase of respiratory-tract infection with Pseudomonas aeroginosa have been recently observed.
We have studied the effect of Kasugamycin (KSM) on respiratory-tract infection with pseudomonas aeruginosa.
The cases were 2 cases of secondary infection with cavity drainage, secondary infection after cavernostomy, secondary infection after lobectomy, mixed infection of bronchial fistula, empyema, chronic bronchitis, bronchectasis, pulmonary abscess with pseudomonas aeruginosa.
1. The effect of Kasugamycin (KSM) I. M. (1g/day for 10 days.)
Result; effective 1 case. None effective 5 cases.
Side effect; all cases complained of local pain for injection, anorexia, and 1 cases showed increase of blood urea nitrogen.
2. The effect of local injection by 12.5%-5% KSM solution
Result; 5 cases became negative for Pseudomonas and 1 case showed decreased number. The effect was splendid.
Side effect; 1 case showed laryngitis
3. The effect of inhalation of 2.5%-2% KSM solution
Result; 2 cases became negative for pseudomonas but 1 case was not effected, Side effect; 2 cases complained of hoarseness.

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According to the generation or authors, the begriffs of occupational therapy transferred. Therefore, the development and progress of it have been delayed.
When occupational therapy carries into practise, we should like to take psychodynamic approach in Japan that trample upon human rights and democracy.
If occupational therapy carries into practise from this point of view, in company with psycho-drugs, patient's prognosis may be optimistic.
The humanitarian or charitable occupational therapy, in spite of being superficially good, would not necessarilly be effective.
Occupational therapy should not be a sort of diversion.
As occupational therapy makes the psychological place for the sake of good communication, so it's progress and it's product would become the tool.
The therapist of occupational therapy should have sensitive and generous characters.
Through the treatment, within the limits being not threatened, occupational therapist should give the patients a sort of stimulation.
Although it is profitable to have many and excellent staffs, untrained personnels becomes to be effective if they participate in therapeutic team by means of co-operative manners.
Recently, it is said, a shortage of employee among many companies and factories.
We wonder, what does not employ the physically and mentally disabled people.
Generally speaking, department of occupational therapy would be despised from most mental hospitals themselves, moreover, the practice of treatment would be referred to untrained staffs.
I think, by way of this connection, occupational therapy has not only no effect but gives a sort of injurious influences.
Both doctors and administrators should take a serious view of occupational therapy from this time.

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For detection of the early gastric cancer, excellent resolving power would be wanted to find out a minute lesion and the optimum conditions for photographing the gastric mucosa with accurate coloration should be clarified.
1) Resolving power of gastroendoscopic instruments
Resolving power is one of the most important characteristics of optical instruments.
As slides, we defined resolving power which was calculated by measuring the disordered circle of the Siemens' test chart.
Resolving power of focusing fiberscope is the best and then GT-V, GTF picture, and GTF in visual use is the last. According to these studies, focusing fiberscope is suitable for detail observation, and correct clinical application of GTF may be said that visual observation should be used chiefly to find out lesion, and differentiation of the malignancy should be decided by its picture.
Resolving power of gastroendoscopic instruments are generally more excellent than that of X-ray. Therefore, it is stressed the necessity of combined method of X-ray and gastrocamera for routine gastric examination.
2) Light-volume of gastrocamera and GTF
We had devised a Gastrocamera Lamp Tester to know light-volume of the lamp. By this machine, we can find out easily less brighter lamp, fitted into instruments. Light-volume of GTF with single lamp decreases rapidly. Light-volume with double lamps decreases so gradually as to be able to applied as 50 patients. Also, light-volume of gastrocamera decreases gradually with repeated examination. When we tested lightvolumes of all gastrocameras at a certain hospital at the same time, we found marked deviation in each light-volumes. Therefore it must be necessary to check light-volume periodically. We must remember that it is not definite voltage of the regulator but the optimum light volume on which our caution must be paid at gastrocamera examination.
3) High-speed photographing
Flash time of gastrocamera regulators are 1/20 sec. for current type, and 1/15 sec. for GTF. We had devised the new GTF Regulator with High-speed Flash. Flashing curve of GTF are observed by synchroscope. Integration of this curve gives light-volume.
According to our experiments about the photograph of rotating Siemens' test chart by GTF, the more sharp picture, with higher resolving power could be taken under the conditions of the faster flash time, the more further distance and the slower movement of the object.
Clinical applications of high speed photographing. In the case of the gastric ulcer at the angle, the sharpest picture was taken at high speed flashing of 1/60 sec. In the other case of the early gastric cancer, IIc type, at the anterior wall of the angle, the slightly depressed area, in which the cancer was infiltrated, was the most clearly showed at 1/30 sec. with the most distinguished color contrast of red and white.
4) Fundamental studies on the gastrocamera films
According to color densitometry of GTF picture taking the neutral gray chart, accurate representation can be obtained at the conjuncted part of yellow, magenta and cyan curves. The latitude, which means the range of the optimum photographic condition of GTF, can be given by measuring the range of the light-volume, in which three curves are conjuncted.
The latitude of Ektachrome 125 is the widest. Resolving power of GTF films are the most excellent at Agfacolor Ck 17 S, and then Anscochrome 32, Ektachrome 25 and 125, Anscochrome 100 is the last. At the outrange of the latitude, which means the inadequate light-volume, it may be caused that the color balance is disturbed and resolving power decreases remarkably, and finally, correct diagnosis would not be anticipated.
Conclusion:
Recently accurate and fine observation about slight decolorations and deformities of the gastric mucosa is required for gastroendoscopy. For this purpose, we have tried to study on the optimum photographic conditions of gastroendoscopy, from the stand-point

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In Japan one definition and classification was employed by pathologist, radiologist and endoscopists in 1962. When the cancerous invasion is limited within the mucous and submucous layers, we define as early cancer. Macroscopic classification of early gastric cancer is classified in 5 types. (I. Protruded type, II a. elevated type, II b. flat type, II c. depressed type, III. excavated type.). 150 cases of early gastric cancer have been operated on in the 4 years since the commencement of our hospital in 1962.
Endoscopic feature on 150 cases of early cancer are reported with the following conclusion.
(1) Protruded type is a polypoid carcinoma. A polyp larger than 2cm in its greatest dimension is frequently found malignant. Uneveness of surface, broad base, hemorrhage of polyp suggest malignancy.
(2) Elevated type (II a) is an early carcinoma of low plateau type. This type in its pure form is rare.
(3) Clinical diagnosis of flat type of early cancer was considered to be imposible but recently it has become possible by detecting a zone of fading color and paleness.
(4) Deppressed type is commonest type of early cancer of the sfomach. Characteristic features are an irregular shaped well demarcated shallow mucosal deppression with an uneven hemorrhagic dirty coated surface. Mucosal fold are disrupted at its margin. Diagnosis of this type is usually easy.
(5) The excavated type (III) is very difficult to distinguish from benign ulcer. Most cases have a narrow zone of shallow depression around the deep excavation.
In this report, contribution of gastrocamera in the establishment and development of the increasing accuracy of the diagnosis of early cancer of the stomach was demonstrated. We confidently expect further advances in this field in the near future.

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A gastric cancer is defined as early cancer when the cancerous invasion is limited within the mucous and submucous layers. Early gastric cancer is classified in 5 types. This report describes the endoscopic differencial diagnosis, limitation of endoscopic diagnosis of protruded type and elevated type of early gastric cancer.
Material: 102 cases of adenomatous polyp, 16 cases of submucosal tumor, 28 cases of protruded type of early cancer, 6 cases of elevated type of early cancer, and 10 cases of (III+IIc) type of early cancer were obtained in our hospital from 1962 to 1966.
Results. (1) protruded type is a polypoid carcinoma. If examination with gastrocamera is carried out properly the risk of missing such a polypoid lesion is very low. However differentiation of benign and malignant polyps is often difficult. 72% of polypous lesion more than 2cm in diameter were malignant. (2) Uneveness of the surface, broad base hemorrhage and central depression suggest malignant. (3) Redness of the surface is observed not only in malignant polyp but also in a benign one. Fading color and paleness of surface are found sometimes in malignant. (4) Polyp smaller than 2cm with stalk is almost benign. (5) Irregular, map-like, warm-like tumor is almost malignant, but round, oval tumor is benign. (6) II a type is an early carcinoma of low plateau type, the height of which is less than the thickness of gastric mucosa. II a type in its pure form is rare but found commonly in combined types (IIa+IIc). Endoscopic demonstration of type II a carcinoma is easy, for the elevation become distinct with inflation of the stomach with air. Differential diagnosis of this type is sometimes very much confusing. Fiberscopic biopsy are requested for the questionable cases. (8) Gastric polyposis was almost benign but in a case with diffuse polyps mucosal cancer was found. (9) It is difficult to differentiated whether malignant or benign but we confidently expect further advances in this field in the near future.

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The authors report 62 cases of stomach polyp discovered out of 4, 000 cases by means of the gastrocamera and fiberscope for these 6 years from August, 1960 to March, 1965.
Though the definition of the gastric polyp would not be conclusive yet, the authors define as following; gastric polyp is the clearly localized protrusion of the gastric mucosa toward the gastric lumen.
Fourteen cases among 62 were confirmed by operation.
Among 4, 000 cases 62 (1.6%) of them were diagnosed as gastric polp.
Thirty-six cases were male and the other 26 female.
The polyps were found most frequently from the fourth to the sixth decade.
Forty-eight cases (77.4%) were solitary and most of them were located at the antrum.
Eight polyps (12.9%) were pedunculated and the other 54 (87.1%) sessile.
The mucous membrane surrounding the polyp was found to be pathological in all cases.
As to accompanying, atrophic gastritis in 67.7%, superficial atrophic gastritis in 27.4%, superficial gastritis in 4.8% and normal in 0%.
Most of patients complained of epigastric pain or fullness.
The gastric juice revealed 3 normal, 8 achylia, 4 hypoacidity and 4 hyperacidity.
Occult blood in the stool was negative in 3, positive in 30.
A relationship among X-ray diagnosis and endoscopic diagnosis was described.
In histology of 14 cases, adenoma in 10, fibroma in 1, gastric tuberculoma in 1, parasite granuloma in 1, early gastric cancer in 1, and one case was particularily difficult to determine its malignancy.
According to many previous reports and our experiences, bleeding, dirty coating, erosion, irregularity of form, broad base, uneven surface, changes of the surrounding mucous membrane, bigness and sessileness are noteworthy findings in malignant cases.

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Chronic gastritis is one of the most frequently encountered disease, which is supposed to be caused by a number of elements.
Since the developement of anti-tuberculous chemotherapy, gastro-intestinal disorders have commonly occured in patients on long term anti-tuberculous chemotherapy. However the relation between chemotherapy and gastro-intestinal disorder is not well understood.
With the aids of recently advanced gastroscopy, gastric disease, especially chronic gastritis has been precisely diagnosed.
We analyzed gastric complaints of patients received long term anti-tuberculous chemotherapy and performed gastrofiberscopic examination of these patients to study the relationship between chemotherapy and gastric disorders.
The results are summarized as follows:
1. Approximately 70% of 159 patients on chemotherapy had gastric complaints and nearly half of them developed symptomes after they began to use chemotherapoietics.
2. The most commonly encountered gastric symptomes were anorexia, fullness of stomach and heartburn.
3. The most common gastric disease found by the gastrofiberscope were atrophic gastritis.
4. Atrophic gastritis was found more frequently in aged patients and in patients on long term anti-tuberculous chemotherapy, compared with superficial gastritis.
5. Some patients with gastric complaints showed no pathological findings in gastric mucosa on gastrofiberscopic examination.
As Shioda et al pointed out, gastric complaints of patients on chemotherapy are not necessarily caused by a direct impairement of gastric mucosa. The fact that some of the patients with gastric complaints showed no pathological findings in gastric mucosa in our study confirmed the report of Shioda et al.
The types and frequency of chronic gastritis of patients on chemotherapy showed similar tendencies with those of non-tuberculosis patients.
Anti-tuberculous chemotherapy may become the cause of gastric complaints and of chronic gastritis of patients using these drugs, however, it is presumed that no particular disease process may be brought about by these chemopoietic agents.

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The author looked up the compound change of parenteral injections by thin-layer chromatography.
The results of the experiments described in this paper are summarized in Tabele 1.
1) Compound of 100mg Vitacimin inj. with Solita-T No. 1. inj.
2) Compound of 100mg Guronsan inj. with Solita-T No. 1. inj.
3) Compound of 5% Transamin inj. with Solita-T No. 1. inj.

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Post-surgical ureter stricture is caused in most by ligation of the periureter tissue and curvation of ureter at the surgical procedure of anterior and posterior vesico-uterine ligament. However, we experienced the cases in which ureter was stricted by unusual adhesion on the crossing part of common iliac artery. In this presentation, clinical courses of the patients, personal opinion on prevention and treatment of this kind of complication were reported.
Case 1. Operation and post-operative course were favourable. The sign of ureter stricture of both sides was seen 60 days after surgery and died of uremia on the 167th post-operative day. Autopsy revealed that both sides of ureter adhered at the crossing part of common iliac artery to obstruct.
Case 2. Ureter stricture of the right side was suspected on the 32th post-operative day, and the stricture was diagnosed by relaparotomy on the 40th day. As isolation of ureter from adhesion was impossible, the stricture was made loose by catheterization.
In order to prevent this kind of disturbance of the ureter it is recommended not to isolate ureter from common iliac artery. When it is needed to do so, ureter should be cathetered to make least the contact area of ureter and artery. The intraperitoneal position of ureter in which the peritoneum is placed between ureter and artery will be an effective method.
Ureter catheterization should be performed to treat the strictured ureter. If impossible of this, prompt surgical procedure to eliminate the stricture will be needed. Even if the stricture develops on one side, these methods of treatment are necessary to keep the function of kidney on the involved side normal.

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The authors made statistic observations of the tuberculous patients treated at the dispensary, Mongkol-Baurei, Battambang, Cambodge, the following results being obtained.
1/- The average living space was 25 square meters for a family of six persons in the high percentage (73.8%) of the households examined.
2/- The average children were 4 per a family.
3/- 39% had less than one room, 39.71% had two rooms and 1% had five rooms.
4/- The average occupancy per room was 3 persons.
The last, but the most important thing is that the above-mentioned report was observed at a far-away village like Srok Mongkol-Baurei, and was by no means a report observed in the large cities of Cambodge. /-

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