In recent years aggregation of radioactive human serum albumin has chieved wider usage in radioisotope scanning. This technique was carried out on many patients with pulmonary diseases for diagnosis and prognosis of these diseases in our clinics.
The following results were obtained.
1) No abnormalities in the scan were shown on diffuse alterations of the lungs.
2) Pulmonary diseases with abnormalities of effective pulmonary blood flow such as pulmonary tuberculosis with chronic changes including cavities and fibrosis, pulmonary emphysem, and pulmonary cancer caused either defects of dot or poor concentration in the scan.
3) On some cases there were no relations between defect of dot and pulmonary blood flow. Further study concerning this matter should be performed.

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Author made a statistical observation on early radiological signs in Legg-Calve-Perthes diseases of 21 cases.
The resultsare follows: -
1. Most frequent change observed during early stage was Waldenstrom phenomenon on 95 percent of all. This phenomenon is important in early diagnosis.
2. Secondary, rarefaction in the lateral outline of the epiphysis close to the epiphyseal plate, translucent area in the medial metaphyseal zone (Gill-sign) are relatively frequent signs.
3. Rarefaction or rounding of the lateral margin of metaphysis, band-shaped Osteoporosis in the metaphysis close to the epiphyseal plate, irregular contour of the epiphysis, a stripshaped subcortical translucent area, bulging of the joint capsule and condensation in the epiphysis revealed early stage.

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The present experiment was carried out to investigate the early diagnosis of cancer by the analysis of the urine. The urine of cancer patients was extracted by ether and the extract was evaporated to a small amount. The evaporated extract was applied on strips of filter paper for chromatography, run with 0.25 N acetic acid solution, and stained by Ehrlich reagent. Color spots were found at a Rf 0.57, and the color spots were defined as follows: blue spot is negative, faint yellow is doubtfull and dark yellow is positive.
The present urine of gastric cancer showed 89.5 per cent in positive and 1.2 per cent in negative, and the spot from liver cancer showed 100 per cent in positive and 0 per cent in negative. The urine samples of cancer patients including gastric, liver, rectum and pancreatic cancer showed 78.9 per cent in positive and 8.7 per cent in negative. The samples from gastric ulcer and non-malignant tumor patients were 18.3 per cent positive and 60.2 per cent negative.
The doubtfull spots were found 9.4 to 21.5 per cent in all urines. The determination of the spot is now investigated.

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Mycobacteria 120 and 3B were both non-sensitive either to phage A-6, B-1, P-1, P-3 or P-4. When bacterium 120 alone or in combination with 607, Jucho, or 3B was attacked by a mixture of those five phages, the non-filtrate of the culture was lytic to 3B cells. The lytic non-filtrate was able to be transferred and propagated successively on the 3B, and after the purification by means of successive propagation many phage particles were found under an electronmicroscope.
The lytic activity of the purified phages was restricted to the 3B cells. The possibility that mycobacterium 120 is a lysogenic strain which liberates new phage particles lytic to 3B cells was ruled out, since bacterium 120 was proved to be non-lysogenic.
As seen in Table 3, strain 120 which was non-sensitive to each of the original phages was found positive to spot test by lysates of 3 kinds of mixed cultures. It is highly plausible, however, that these results of the spot test owe to some kinds of growth inhibitors in the culture or abortive infection by lysates, sine no plaque was observed by plaque-count method.
Four types of phages, SAR, SBR, SMU and SLU, which were newly obtained in this experiment, were quite similar to each other in their morphological characteristics observed under the electronmicroscope and in their cross resistance. However, the individual strains of the new phages were distinguishable by their serological characteristics.

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Three cases of pulmonary actinomycosis were reported, because of difficulty of differentiation from pulmonary tuberculosis, lung cancer and lung abscess.
Case 1. 61-year-old man.
He had cough, sputum, emaciation and chest pain, as chief complaints. The complicated sign and symptom made difficult diagnosis. Finally, from pathological examination of neck actinomycosis, he was diagnosed as pulmonary actinomycosis and cured with massive penicilline therapy.
Case 2. 48-year-old man, complaining of fever, chill, cough and sputum, was admitted with suspected lung abscess. The actinomycosis was found by pleural fluid culture, and he was diagnosed as pulmonary actinomycosis.
Case 3. 25-year-old man, was admitted as pulmonary tuberculosis. After bronchoscopy was done, he got sore throat, fever and dyspnea. He died with spontaneous pneumothorax with pyothorax. Autopsy disclosed mediastinitis and pyothorax due to actinomycosis. The difficulty of differentiation was discussed.

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We have analysed the compound change of Thioctan injection with other injections, often used together, by thin-layer chromatography with following conditions.
Wakogel B-5 was used as an adsorbent.
Thioctan injection was compounded the same equivalent with another injections.
Developed with the Developing Solvents described in Table 1.
Kl·H₂PtCl₆ was used as color reagent.
And we examined Rf values of the compound change about appearing spot.
The results were summarized in Table 1 in which there was no compound change between two structures.

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The results of the drug resistant test of the secondary antituberculous agents, KM, CS and TH in 1, 220 (69.7%) of 1, 750 patients who were selected from 4, 935 in-patients in 15 national sanatoriums in Kyushu district were surveyed.
The results were as follows:
(1) In order of frequency, the patients with cultures resistant to one of the secondary drugs, KM, CS and TH were 393 (32.2%), patients with cultures resistant to two of the secondary drugs were 232 (19.0%) and the patients with cultures resistant to three of the secondary drugs were 98 (8.0%), which summed up to 723 (59.3%) in all and the highest incidence, more than a half, in patients with cultures resistant to one of the secondary drugs.
The frequency of resistant rate varied greately in each sanatorium, ranging from lowest 13.6% to highest 81.5%.
(2) Of 723 patients who showed the cultures resistant to secondary drugs were divided into 32.6% in KM resistance, 33.4% in CS and 28.2% in TH.
Frequency of resistant rate on basis of each drugs differed greately in each institutes, being lowest 9.0% in KM, CS and 4.5% in TH resistance.

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One thousand seven hundred fifty of 4, 935 in patients in 15 national sanatorium in Kyushu district revealed positive tubercule bacilli in the sputum culture. Of these 1, 750, 1, 220 patients were examined in regard to the drug resistant test of the primary and secondary antituberculous agents (KM, CS, TH).
The results were as follows:
(1) Sum of patients with cultures resistant to the three primary and the three secondary drugs greately differed in each institutes. Of patients with the primary and secondary drug resistance in 15 national institutes, the order of frequency of the combined drug resistance were three-drugs, two-drugs and four-drugs resistance. The frequency of the above three resistance rate were 62.3%.
(2) Of the 1, 220 patients with sputum examination for sensitivity test in 15 national sanatoriums, a total of patients with cultures resistant to the primary and secondary drugs were 1, 060 (86.9%). 1, 013 (82.9%) of those were resistant to primary drugs. A total of patients with cultures resistant to both primary and secondary drugs were 676 (66.7%).
The proportions of the resistance rate of the secondary drugs in patients with a three-, two-, one-, and no-primary drug resistance were 71.2%, 66.7%, 60.6% and 22.7% respectively, which revealed the slightly high incidence of resistant rate of secondary drugs in patients with multi-primary drug resistance and patients who were sensitive to primary drugs and resistance to secondary drugs were not uncommonly encountered. Moreover, of patients with both primary and secondary drug resistance, the numbers of patients with cultures resistance to one secondary drug only were 363 (35.8%) which were over the half of the total.
Of patients with secondary drug resistance, the frequency of resistance to SM, PAS and INH were 550, 491 and 409 respectively. Each frequency of KM, CS and TH resistance in patients with a primary resistance was 378, 382 and 324.

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The authors observed 531 cases above the sixth decade (312 males and 219 females) among 10, 524 cases of all outpatients during past four years and a half.
Incidence of the cases of pruritus senilis above the sixth decade was 14.7%, and almost of these cases had hypertension and dysfunction of kidney.
In all cases of herpes zoster, incidence of the cases above the sixth decade was 35.4%, and these cases had been treated longer than the cases of younger age.
The authors found 5 cases of leucomelanosis caused by administration of hypotensive agents (thiazide derivatives).

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It calls attention that mental disorders in old age are comparatively increased for the benefit of prolonged average span of human life, and geriatric psychiatry is being brought up into a key subject of gerontology.
Noticeable physical condition appeared in geriatric mental disorders is organic psychosis. such as arteriosclerosis cerebri and senile dementia. Therefore, diagnosis and treatment of those patients should be based on comprehensive knowledge of geriatric phenomenon in nerve tissue.
There is also not small numbers of functional psychosis such as neurosis, depression, and delusion syndrome, besides organic psychosis caused by geriatric brain diseases. Furthermore, not only physical degeneration by senile but also social, cultural and economical circumstances are involved in occurrence and process of presenile and senile mental disorders.
I propose herein to discuss 1) statistical consideration of geriatric mental disorders, 2) diagnosis of presenile and senile psychosis and 3) problems in treatment and care for geriatric mental patients.

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To clarify the changes of the gastric mucosa of the aged, following two methods were adopted. At first, the changes of the gastric mucosa with aging were studied, not only on the aged but also on the younger. Secondly, the groups of mass survey and outpatient at the hospital of Tokyo University were subjected.
1) Statistics of gastritis with aging.
The gastritis, here discussed, was restricted to the gastritis recognized by gastroendoscope regardless of complaints. By the results of the mass survey by means of the combined method of gastrocamera and indirect X-ray at the same day, type of the gastritis was as followings; atrophic gastritis was 47.0%, superficial gastritis was 8.4% & hypertrophic gastritis was 1.7%. By the mass survey, the incidence of the gastritis increased with aging, especially over the fourth decade. The incidence of the gastritis of the male exceeded a little bit than the female. The grade of the atrophic gastritis progressed from the fifth decade. Alteration from the normal gastric mucosa to the atrophic gastritis seemed to progress from the fouth or fifth decade. About the acidity, the incidence of the anacidity increased with aging, especially over the fourth decade. At the same time, the incidence of the normacidity and hyperacidity decreased with aging. The incidence of the atrophic gastritis of the clinic was more than of the mass survey. The incidence of the complaints of the atrophic gastritis in the younger was more than the aged. The incidence of the complaints of the patient with normal gastric mucosa was less than with the atrophic gastritis. The incidence of the complaints of the patient with the atrophic gastritis of the female was more than the male.
2) Statistics of gastric ulcer with aging.
By the results of mass survey by means of the same method, as above mentioned, the incidence of the gastric ulcer with aging was the most at the age of 40 yrs. But, the incidence at the clinic was the most at the age of 50 yrs. The incidence of the gastric ulcer of the mass survey was 6.3%. This high incidence of the disease seemed to be caused by the application of gastrocamera examination to the first screening. Almost all the patients of the gastric ulcer were of normacidity or of hyperacidity. The incidence of the anacidity of the gastric ulcer increased gradually with aging. Healing: tendency became worse with aging, that may be caused by the decreased ability of regeneration of the gastric mucosa of the aged. Relation between the ulcer and the cancer has been discussed for a long time. The clue might be given by the progress of gastroendoscopy, especially fiberscopic biopsy.
3) Statistics of the gastric polyp with aging.
The gastric polyp was discovered by use of gastrocamera with high frequency. The incidence of the disease by the results of mass survey by means of our method was 0.5%, and increased rapidly with aging. The incidence of the disease at the clinic was more than at mass survey. The malignancy of the polyp was highly observed in the lesion over than 2 cm of its diameter.
4) Statistics of the gastric cancer with aging.
The gastric cancer is one of the most important disease in our country. The only curative treatment is the detection and its resection at the early stage. Mass survey is very important method to discover the early gastric cancer. The application of gastroendoscopy, fiberscopic biopsy and cytology may be said to aim chiefly for this purpose. The only method to discover the early gastric cancer without any complaint is mass survey. The incidence of the gastric cancer increased from the 4th decade by our results of mass survey, and the most at the age of 50 yrs. The incidence of the male was more than the female. The acidity of the patient was generally anacidity, especially over than the age of 40 yrs. The gastric cancer frequently accompanies with atrophic gastritis. The atrophic gastritis accompanied with the early gastric cancer is usually m

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It has been studied in the ratio of cases of heart diseases to that of all diseases in our clinic for 10 years. Coronary sclerosis and heart diseases increased as increasing of ages, especially over 60 yrs old. It was suggested that aging is one of the most important factors in deterioration of heart failure in aged.
An attempt was made to study the bleeding in the digestive system in heart failure in aged. 313 cases of heart diseases were studied and it was shown that 11 cases of such 15 bleeding cases existed in over 50 yrs old, but it's etiology was unknown and their pathological finding was diffuse submucosal bleeding and petechiae in the digestive tract. There were no time relations between the deterioration of heart failure and such bleeding in the digestive system, and between such bleeding and death. Also their symptoms were abdominal pain, tenderness of the abdomen or muscular defence, but many of cases had precede diarrhea.
An attempt to clarify the relationship between some specific functional changes in the circulatory system and such bleeding in these patients was made.
There were 2 cases with digitalis intoxication before these bleeding, 4 cases with arrythmia, 5 cases with diuresis induced by diuretics (4 cases of them had arrythmia) and 10 cases with deterioration of heart diseases.

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In a co-operative study on leukemia conducted at 17 National Hospitals during the 6 year period from July 1, 1959 through June 30, 1965, the prognosis of 151 cases of acute myeloblastic leukemia was examined with regard to presence or absence of the selected clinical manifestations such as fever, hemorrhage, level of white blood cell counts, percentage of myeioblast in peripheral blood and that of bone marrow at the initial examination on admission.
The rate of 8th week survival from the start of treatment was used as the prognostic index.
Of the 151 cases, 112 cases, were treated with corticosteroid and 6-Mercaptopurine in combination, 15 cases were treated with corticosteroid alone, and 14 cases were treated with a combination of corticosteroid, 6-Mercaptopurine and Nlitomycin-C.
1. The survival rate of the higher body temperature group (above 38°C) was 34.0% and that of the lower body temperature group (belew 38°C) was 46.9%; no statistically significant difference between these.
2. The survival rate of hemorrhagic group (29.6%) was lower than that of non-hemorrhagic group (53.7%) with statistical significance.
3. The survival rate of the group of higher level of white blood cell counts (above 50, 000/cmm) was 30.3% and that of the lower level group (below 50, 000/cmm) was 46.% no statistically significant difference between these.
4. The survival rate of the group of higher percentage of myeioblast in peripheral blood (above 80%) was 31.6% and that of the lower level group (below 80%) was 45.9%; no statistically significant difference between these.
5. The survival rate of the group of higher percentage of myeioblast in bone marrow (above 80%) was 43.7% and that of the lower level group (below 80%) was 41.7%; no statistically significant difference between these.
6. The survival rate of the cases with a lower level of body temperature in non-hemorrhagic group was 63.3%, that of the cases with a lower level of body temperature in hemorrhagic group was 35.1%, that of the cases with a higher level of body temperature in non-hemorrhagic group was 41.6% and that of the cases with a higher level of body temperature in hemorrhagic group was 29.1%; there were statistically significant differences between the first group and the second group and between the first group and the third group.
7. The survival rate of the cases of a lower percentage of myeloblast in peripheral blood in non-hemorrhagic group was 57.2%, that of the cases with a higher percentage of myeloblast in peripheral blood in non-hemorrhagic group was 50.0%, that of the cases with a lower percentage of myeloblast in peripheral blood in hemorrhagic group was 34.1% and that of the cases with a higher percentage of myeloblast in peripheral blood in hemorrhagic group was 21.7%; there were staististicalIy significant difference between the first group and the third group and between the first group and the fourth group.
8. The survival rate of the cases with a lower level of body temperature and a lower percentage of myeloblast in peripheral blood in hemorrhagic group was 48.2%, that of the cases with a lower level of body temperature and a higher percentage of myeloblast in peripheral blood in hemorrhagic group was 11.1%, that of the cases with a higher level of body temperature and a lower percentage of myeloblast in peripheral blood in hemorrhagic group was 36.3%, that of the cases with a higher level of body temperature and a higher percentage of myeloblast in peripheral blood in hemorrhagic group was 11.1%, that of the cases with a lower level of body temperature and a lower percentage of myeloblast in peripheral blood in non-hemorrhagic group was 68.3%, that of the cases with a lower level of body temperature and a higher percentage of myeloblast in peripheral blood in non-hemorrhagic group was 55.4%,

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The followings are the results of clinical investigation and consideration upon 99 eases of C. B. (chronic bronchitis) by the Fletcher's definition, but 49 cases are not applicable to the definition, i. e., no cough and sputum over 3 months in a year.
1) Some patients had had only cough and sputum for long time, and it is considered that these cases had different etiological factor.
2) Many cases of C. B. have abnormal shadow on the chest X-Ray film, even if no particular C. B. symptom is found on the X-Ray film. When the dissemination of linear, granular or reticular shadow are found, C. B. should suspected.
3) Bronchography is absolutely necessary for the diagnosis of C. B. It is considered that the basic sign is the irregularity of bronchial wall.
4) The necessity of the treatment and observation is required for the C. B. patients who are not applicable to the Fletcher's definition and has relatively light symptoms.

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The author reports 21 cases of congenital arteriovenous fistulae and 9 cases of traumatic arteriovenous fistulae in last 10 years. The clinical pictures and surgical indications are presented. The characteristic clinical courses are demonstrated. The complicated haemodynamics should be considerable for treatment of arteriovenous fistulae.
The most cases of congenital arteriovenous fistulae are multiple type. The excision of the lesion or ligation of the fistulae is not possible in the diffuse type of congenital arteriovenous fistulae except partial excision including a limited amputation. However localized type can be excised and relatively good surgical results are obtained. Varicose veins of congenital arteriovenous fistulae should not be indicated vein stripping except multipule ligations in the extremities.

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Two newborn infants with hemorrhage of the adrenal glands are presented.
Case I. A boy of 3, 050gm, was borne in protracted delivery at the Chiba National Hospital. He had difficulty of breathing, cyanosis and pale, and died on the next day with progressive down-hill cowrse.
In post-mortem examination, the most important finding were the hemorrhage of the right adrenal gland.
The left gland was intact.
Case II. A boy of 4, 100gm, was borne at the Chiba National Hospital.
He had cyanosis, cramp, difficulty of breathing, apnoeic spell and fever. His condition was gradually improved with O² inhalation, antibiotics etc, and was discharged on the 20 hospital days. At 2.5 months of age he was noted to have hepato-splenomegaly and calcification in region of both adrenals on the scout film of the abdomen.
Operative finding and microscopic examination revealed the calcification of the glands presumedly resulting from hemorrhage at the newborn stage.

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So-called SMON is an abbreviation of subacute myelo-optico-neuropathy; that is an encephalo-myelitis accompanied with some abdominal symptom, which has been reported in Japan since 1957, and the patients are remarkably increasing in number recently. The causes of this disease being still unknown, each diagnosis depends upon its clinical figures, therefore it is not always easy to distinguish from other similar neuropathies. Kazuya Ando has noticed 17 clinical characteristics of SMON, among which he's pointed out 3 “dominant characteristics” and 5 “important ones”.
The case reported here concerns with a woman aged 42, who, suffering from caries of dorsal vertebrae, entered our hospital in 1948. Since she came here, she has also been attacked with various complications of tuberculosis and is still under medical care in the hospital. In 1960 she was attacked with severe abdominal pains, which was followed by the appearance of some serious neurological symptoms on the lower parts of her body, and she is now suffering from its following complaints. The diagnosis had been left unsettled for several years, and as the notion or SMON was proposed by specialists lately, the author noticed consequently that the clinical figures of this disease was quite similar to SMON. But one question on its differential diagnosis is left unanswered: the dysfunction of deep-sensibility in this case s not remarkable, which is considered as one of characteristic figures of SMON.

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The sorts of tumors originated in tendon sheaths are enumerated as follows;
benign
1 Ganglion……frequent
2 Xanthomatous giant cell tumor……not infrequent
3 Lipoma……rare
4 Hemangioma……rare
5 Lymphangioma……rare
6 Fibroma……rare
7 Osteochondroma ……rare malignant
8 Synovial sarcoma……rare
(Charache)
In this table, the tumors which show clinically interesting features and pathologically debatable natures are xanthomatous giant cell tumor and synovial sarcoma. Xanthomatous giant cell tumor so named here is not genuine neoplasm in strict sence but considered as certain inflammatory growth which is in reality identical with pigmented villonodular tenosynovitis (Jaffe Lichtenstein). This condition is clinically divided into two types of localized and diffuse form. The former is undoubtedly not infrequently recognized as localized solid tumors at tendon sheaths of the hand or foot, but clinical cases of the latter have been rarely reported and total removal of this tumor may not finish with usual success.
Accurate diagnosis of synovial sarcoma is commonly difficult by reason of variation in histological details from case to case. The microscopic features of this tumors is characterized by appearance of two cytological phase, i. e. fibrosarcomatous and synovial componnet. The fibrosarcomatous component consisted of the spindle-cellular tissue misleads to such an impression of the fibrosarcoma. The synovial component is the parts that is mainly dominated by distinctive glandlike structure.
The presence, in any case, of the both components in full visualization is so the most valuable finding that it would be obviously different from other tumors.
The Four typical cases of such diseases were encountered as below mentioned.
Case No. 1 pigmented villonodular tenosynovitis
A female, 52 years of age. Since about fifteen years ago, she has felt slight painless swelling around the M. P. joint of the right index finger. It enlarged gradually and developed into a conspicuously inflated tumor.
Removal was made at Feb. 12th, 1965. It has arisen from tendon sheaths of m. ext. dig. comm. (index finger) and m. ext. prop. indicis.
Because it expanded diffusely into the surrounding tissue, this tumorous content could not be completely removed.
Case No. 2 localized nodular tenosynovitis.
A female of 36 years old. At just one year ago, she had experience of slight trauma that an iron failed accidentally on her left instep, afterward a small induration has subsequently remained.
It went by consistently painless but grew into a solid tumor of the thumbtip-size. This growth was removed at July 28th, 1967. It originated in tendon sheaths of m, flex. dig. brev. et long. (the second toe) and its surface was all wrapped by thin membrane of the connective tissue.
Isolating from the circumference could be easily made.
Case No. 3 synovial tumor
A female of 35 years old. Since about seven years ago, she has noticed a subcutaneous small node between the thumb and the index finger.
It enlarged progressively and grew into so big plump tumor that functional disturbance and hypaesthesia of the thumb has occurred. Removal was made at July 8th, 1965. This tumor based originally upon a tendon sheath of m. flex. poll. long and has deeply extended into muscle-bellys of m. adduct. poll. and m. opponeus, but total extirpation was not so difficult because of capsulated tumor formation.
The content was red-brownish colored and was equally elastic soft.
Case No. 4 synovial tumor
A male, 23 years of age. Since about 10 years ago, a small node has appeared at dorsal and radial side of the right wrist, and at that time it was diagnosed as ganglion. He left this tumor as it is because it has been grown not so rapidly and maintained continuously the symptomeless condition ever since.
At Jan. 26t

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We state about the operations which we had done for past one year, since the establishment of Shikoku Regional Cancer Center in October, 1966.
As changing the kind of patients, the major operation was increased in number in contrast with decrease of appendicitis, inguinal hernia and etc.
The operations to the malignant neoplastic disease which we had operated were 172 cases, while the other kind of disease were 244 cases. The number of operation of malignant neoplastic case was followings; stomach 93, breast 13, colon 10, rectum 4, pancreas 3 and thyroid gland 3. The operation of the cancer of stomach were 91 and 13 of them were early cancer (according to rules established in Japanese Research Society for Gastric Cancer).

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