For the purpose of evaluating the histogenesis and developmental process of carcinoma of the cervix, 550 cases of benign cervices, 103 cases of borderline lesions and carcinoma in situ, and 72 cases of early invasive carcinoma were histologically studied.
In benign cervix, between squamous and colummar epithelium, there is transitional zone, which epithelial component is all stages of growing process of reserve cells.
These proliferating reserve cells are supposed to be the probable source of early malignant change, because of its location and morphologic resemblance to dysplasia and beginning in situ.
When early stromal invasion occurs, the histological differentiation should be made, whether the invading foci has evidence of proliferation.
The former should be treated radically, its invasive character being similar to the ad_d vanced cancer, while the latter may be treated as carcinoma in situ.

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Among the blood diseases, what may be the indication for the corticosteroid-therapy were chosen.
1) The occurence of diabetes mellitus were 5 out of 9 patients in aplastic anemia, 1 out of 9 in acute leucemia, null out of 4 in the others, totally 6 out of 22.
2) Among the 6, 4 had received long-termed steroid-therapy by the time of the onset of diabetes mellitus, the remaining two (both were patients of aplastic anemia), however, had received none.
3) About the remaining two, the onset of diabetes mellitus was coincident with the onset of serum hepatitis following the blood transfusions.
4) All the 6 had received repeated blood transfusions, and moreover all revealed the disturbances of hepatic functions.
From the above observations, it was concluded that diabetes mellitus in patients of blood diseases, esp. of aplastic anemia might be manifested by not only the long-termed corticosteroid-therapy but more significantly the disturbances of hepatic functions. As the cause of the hepatic damage, the serum hepatitis following blood transfusions was emphasized.

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During the period from August 1964 until April 1967 seventy two cases of inpatients were subjected in this investigation of hyperuricemia and chief side effects due to PZA in the treatment of pulmonary tuberculosis.
The results obtained were as follows:
By the colorimetric measurement it was confirmed that after 'administration of PZA serum uric acid level in all of the cases rose up to 6-20mg% and continued during the course of PZA treatment, on the other hand by cessation of PZA it returned to normal value (i.e. 1.8-5.9mg/%) without exception.
On the basis of the results of measurements in which individual tendency in the grade of hyperuricemia during PZA therapy were noticed, we tried to divide all cases into 3 groups and investigate each characteristics.
In our observation, however, any close relationship was not found between the degree of hyperuricemia and the occurrence of joint pain, but all of the cases who had complaints of joint aching were associated with hyperuricemia at the same time, therefore it should be suggested that, although hyperuricemia could be regarded as one of the causes of joint pain, another innate or acquired facotrs in the intraarticular urates precipitation as same as in gout must be taken in consideration for the incidence of joint pain.
Cases with joint pain due to PZA were seen totally 33 out of 72(45.8%), among them over moderate grade aching were observed in 17 patients(23.3%) and that locations were shoulder, knee, ankle elbow, wrist, finger, toe etc. But redness or swelling deformities in those joints were not found.
The effect of uric acid diuretics to joint pain and serum uric acid level varied individually, but almost all cases cured without cessation of PZA by probenecid or phenylbutagone.
We observed some cases whose joint pain due to another causes has become more severe by PZA therapy.
Hepatitis accompanied with jaundice produced by PZA were seen only in 4 out of 72 cases (5.5%), but there were patients with mild impairment of liver function and many cases with increase of urobilinogen in urine.

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This is a statistical study on liver diseases compiled from the patients who admitted to the Department of Internal Medicine, Yokohama National Hospital, in the period between 1945 to 1955.
Patients with liver diseases were divided into following groups: acute hepatitis, serum hepatitis, chronic hepatitis, liver cirrhosis and liver cancer.
We excluded purulental and cardiogenic liver diseases from this study.
Statistical observations on following subjects were made on these groups.
1. Yearly change of the number of patients. 2. High protein diet. 3. Metabolism 4. Catheterization of liver. 5. Drugs employed 6. Follow-up study. 7. Hepatitis of special types. 8. Classification of Liver cirrhosis. 9. Liver cirrhosis 10. Liver cancer. 1) Acute hepatitis: a precise analysis on this subject was carried out. Peaks of the numbers of patients were seen on every five years.
A) 1945∼1955.
The number of patients were fifty, and there were more males than females.
Patients between 20 and 40 years and beyond 50 year occupied higher percentages. More patients were seen in summer than the other seasons. The duration of admission ranged from one to two months.
B) 1956∼1965.
118 patients, almost same numbers of males and females.
Patients under 20 year occupied high percentage. Only slight increase of patients in summer were seen.
The duration of admission ranged from two to three months.
2) Highprotein diet: protein 100gm., fat 35gm, and total Calorie 2400, gave better effects on patients than low protein (80gm) diet. No difference between both regimes were seen among the patients with disturbance of bile outflow.
3) Metabolism. Measurements of BMR and determinations of daily urine Nitrogen were performed. Increases of ten per cent, or more in BMR were frequently seen. The range of the urine Nitrogen values were 18-84gm., calculated as protein, that is, the protein metabolism was in positive balance.
4) Catheterization of liver.
When the disease became more chronic, the metabolism of glucose and protein became worse.
5) Drugs employed.
Liver-pulver, antibiotics, lipotropic substance, liver-stimulating substance, steroid hormone, vitamines and gluthation.
6) Follow-up study.
In 1966, follow-up study cards were sent to 150 patients, whose admissions were in the period between 1953 and 1964. Follow-up was completed on 67 patients. One death (1.8%) and ten cases of liver disease (23%) were listed out of these 67 patients.
There were 3 cases of readmission due to reoccurence of acute symptoms of hepatitis, all of them were heavy drinkers.
7) Hepatitis of specific types.
Toxic or drug induced hepatitis: the drugs were SM+PAS, SM, Brovarin, Pyramide, and Wintermin, and respectively one case was listed. Four cases of pregnancy with jaundice were seen. One of them died of acute yellow liver atrophy. Hepatitis with viral meningeal symptoms 1 case, with viral pneumonitis 4cases, liver cirrhosis with thrombopenic purpura hemorrhagica lcase, hemochromatosis 2cases, and schistosoma japonicum Icase were seen.
8) Classification by post-mortem histological examination in liver cirrhosis revealed as follows: Post-hepatitic type 13, post-necrotic type 2 and Laennec type 7.
9) Percentage of liver disease (excluding purulental and cardiac origin).
*Percentage of incidences out of all patients who admitted to department of internal medicine.
10) Liver carcinoma and liver cirrhosis based on autopsy findings.
*Percentage of incidences out of all autopsy cases in department of internal medicine

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Based upon the clinical experiences of the author, who had worked for eight months and half—from August 1964 until April 1965—at Mongkolborey Medical Center situated in the north-western part of Cambodia, somes notes on the ophthalmic diseases among the inhabitants of this rural area will be described here. That center had three clinics; those were of internal medicine, surgery and gyneco-tocology. The number of patients of the surgical clinic was 1, 855 in all during that period. Two hundred and eight of them (11.2%) consulted us with one or more complaints owing to the ophthalmic diseases. Besides them, several patients came to us with other complaints, who were accidentally found to be suffering from some ophthalmic diseases. They are all contained as the materials in the following statistic figures.
The patients of pterygium numbered 80, and that number ranked first among all kind of ophthalmic diseases. Thirteen of them were younger than thirty years old, and young persons with pterygium were found there not rarely. Each pterygium in most cases was developing, in the nature of the case, from the internal corner of the eye, while seventeen of 80 patients (21.3%) had the pterygium developing from the external corner of the eye. There were some cases with pterygium of the severest grade, which had already grown over his owner's pupil. The internal corners of the eye with such pterygium numbered 24 among the above mentioned 80 patients (15.00 among 160 internal corners of the eye), and the external corners of the eye with such pterygium numbered 3 among them (1.9 do among 160 external corners of the eye).
The number of patients of cataract was 41, which ranked second among all kind of the ophthalmic diseases. Ten patients were younger than 50 years old. There were four patients aged even in their twenties, and young persons with cataract were also found there not rarely.
Contrary to our expectation, there were only a few persons suffering from the ophthalmic diseases belohging to the common inflammations: only 24 cases of acute conjunctivitis and 23 cases of trachoma.
Such pattern of the ophthalmic diseases in this district was assured by the result of our medical research on a small scale for the inhabitants of a little rural village. After this mass examination, namely, 43 cases of pterygium, 14 of cataract and 5 of conjunctivitis were found among 105 adults, while only 2 cases of conjunctivitis were found among 66 infants, who were younger than 19 years old, and none of trachoma was found among; all the inhabitants examined.

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When I consult with psychiatric patients in central consultation office for children, I can find the number of mental deficiency and secondly behavior disorder. As to the complication; there are many cerebral-palsied children, who show very low intelligence, verbal difficulty, walking difficulty and loss of control sphincters.
As to the causation of disease: there are more organic than psychogenic or endogenic. Intelligence: superior 1, moderate 75, low 121.
As to their parents: not questionable parents are 46%, questionable parents are 54%.
As to their fathers: laziness, separation, alcoholism and illness etc.
As to their mothers: separation, laziness and illness etc.
For behavior disorder children's parents, questionable parents are 67%, not questionable parents are 33%. As to the economic state of homes : low grade 59.5%, middle grade 39.2%, and then, as for idiocy, middle grade 75%, low grade 25%.
As to somatic complications: when I devise normal, low, and very low of intelligence, low is more than normal, very low is more than low.

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1 The author tried to lay stress on the pathogenesis of leprosy, and endeavored to presume the modus and course of the infection, intrusion into the body and development of the illness.
2 Then observed and followed up morphologic and functional changes in the R. E. S. concerning above mentioned cases. In particular, studied the tissue reaction in the reticuloendothelial system of lepromatous leprosy, especially, in visceral leprosy. The tissue changes chiefly of that group, undergo hyaline and fatty degeneration and atrophic change markedly.
3 In visceral leprosy, there are characteristic tissue changes occurring in the liver, spleen, lymph nodes, adrenals and in the others. The histologic changes in the R. E. S., in particular, decline in phagocytic cells and fibroblastic cells are recognized.
1) On the microscopic examination, sinuses in the spleen and lymph nodes, and in the sinusoids in the liver and adrenals, and others, have left widely opened but sinus endothels are not increased and atrophied and in particular, desquamative cells in their lumens not be grown, rather consumed and tend to decline.
2) Lymphatic follicles in the spleen and lymph nodes are small in size and number. In the follicles, reticulum cells and lymphatic cells are little germinated. In particular, in the follicles are generally wanting in germinal centers, moreover, some of them underwent hyaline degeneration.
3) In the spleen and lymph nodes, in the splenic pulp and lymphoid tissue vacuolar alteration, resolusion or hemorrhage could frequently be found. In the liver, number of leprous nodules and dissociation of the liver cells could be found.
4 In leprous inflammation occur granulomatous cells owing to endothelial or monocytic cells, but fibroblastic cells seldom be grown. By reason of above mentioning, scar healing in leprous lesion hardly be grown, therefore the lesion is very difficult to recover.
5 In the R. E. cells in leprosy, reactive cells production are very scarce, as well immune substances to the disease may be produced very feeble and scarce. The existence of immune bodies may proved by means of positivity of Lepromin Test.
6 In clinical and immunological study, and also histological, various kinds of exacerbation or relapse may occur. On account of leprous reaction, the most usual matter in fluctuation of the illness as follws. They are E. N. L. (nodular erythema), acute infiltration, reactional recurrence and so on.
7 In conclusion, the difficulties in recovery, especially in visceral leprosy, mostly depends upon histologic changes in the R. E. S. The tissue changes in the organs become incapable to function the proper activity owing to hyaline degeneration and fatty alteration and ultimately inactivity and atrophy of the R. E. S. may be arisen.

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Endoscopic study with gastrocamera and other clinical examination were carried out in order to investigate in 35 patients who had had the gastric complaints as the side effect of antituberculous drugs for a long time.
The results obtained in the present investigation can be summarized as follows.
1) In the endoscopic study, the findings of gastritis were obtained in 30 of 35 patients (86%).
2) It was concluded that the types of chronic gastritis were most correlated with the kinds of antituberculous drugs, and relatively with the types of pulmonary tuberculosis.
3) There were, unexpectedly, findings of slight gastritis in the patients treated with PAS except normal findings in 30%, although they had severe gastric complaints.
4) It was observed, that there were findings of slight atrophic gastritis in the great number of patients treated with sufanilamide, and findings of standard or advanced superficial gastritis in the group of 1314 TH.

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In 1963 276 pulmonary tuberculous patients were admitted to Kanagawa National Sanatorium. They were divided into the group with chemotherapy and without chemotherapy, and they were investigated upon the roentgenographic findings, the.resistance of antituberculous drugs and prognosis. The comparative studies were made between the whole country survey of Ryoken and epidemiological studies in Kanagawa Sanatorium.
Fifty one cases of 91 without chemotherapy had positive sputum at the time of admission to our sanatorium. The drug resistance was found in 12 of 51 and most of all were the Streptomycin resistance. 99 of 185 with chemotherapy had positive sputum at the time of admission to our sanatorium. The drug resistance was found in 68 of 99 (in 97 cares drug resistance were examined) in which S. P. I. (Streptomycin, PAS & I. N. H.) resistance were the most.
During admission, the patients without cavity improved much and this was not related with foregone chemotherapy or drug resistance. Among the cavity cases without foregone chemotherapy, 92% of the cases without resistance and 91% of the cases with resistance improved. Among the cases with foregone chemotherapy, 66.6% of the cases without resistance and 38.8% of the cases with resistance improved but the rest of cases were unchanged, relapsed or died.
As the results compared with Ryoken survey and Kanagawa National Sanatorium, in the rate of the patients with primary drug resistance without chemotherapy Ryoken survey showed 15% and our sanatorium showed 23.5%. In the rate of patients with resistance with chemotherapy, Ryoken survey showed 65.4%, and ours did 70.8%.
In our sanatorium this high rate of drug resistance cases increased yearly, especially in 1963 there were many patients with S. P. I. drug resistance with hardened cavity. It showed the increase of positive sputum at the time of admission as much as the increase of severe cases. These suggest incurability of pulmonary tuberculousis and difficulty of chemotherapy in future.

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The effect of diazepam as an agent for premedication to anesthesia was studied by double blind test using placebo and the result statistically investigated.
The subjects were restricted to 1326 laparotomy and thoracotomy cases which were as alike as possible. Diazepam used in premedication was superior to meperidin which is being generally used in premedication in sedative and antianxiety effect. It was found diazepam given after rising in a dose of 0.1mg/kg was inadequate to premedication when surgical operation was performed in the afternoon. It was statistically shown, however. diazepam to be a useful agent without untoward side effects in premedication to anesthes in the field of anesthesiology.

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We compared the peptic ulcers between brothers, and we are surprised much about the similarity of its age of onset, its symptoms and its localization.
So we must consider the hereditary factors on establishment of ulcers.

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The Hobashira Clinic locating in a remote village, Hobashira District, Saikawa-machi, Miyako-gun, Fukuoka-ken, whose parent hospital is the National Kokura Hospital, was established in July 1982. Since then four years' statistical observations were made.
1) In the first year of opening of the Hobashira Clinic, the average number of outpatient per day was 23.7. After then the number of out-patient degreased year by year as the population in the village decreasing. From 1966 the average number of out-patient per day became less than 20 per day.
In the parent hospital in 1962 the average number of out-patient per day per physician was 33.4, and the average number of patient is increasing year by year up to 35.9 in 1966.
2) Patient's payment per day in the Hobashira Clinic was 220 yens less than that of the out-patient clinic in the parent hospital.
3) During 4 years 68 cases from the Hobashira Clinic were transferred to the parent hospital.
4) Each physician must be spent about 3 weeks in a year in the Clinic in order to carry out medical activity there. In other word, in the parent hospital one member of physician is always absent through a year.
5) Since the opening the Clinic trafic condition around Hobashira District remarkably improved and at present it is only an hour and a half ride from there to the parent hospital.

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